•
For example, on
April 15, 1997, New York psychologist Viola Wiegand was convicted
of billing Medicare for $2.5 million in services she never provided.
Wiegand and four others concocted a scheme whereby "patients"
were solicited to participate in disability insurance fraud by
feigning car and workplace accidents. Wiegand issued reports stating
the individuals suffered from PTSD, then billed repeatedly to
treat their nonexistent illnesses. Eventually they would qualify
for Social Security disability and Medicare and she would sometimes
bill for seeing as many as 35 of them in a day for 60- to 90-minute
treatments. Over a 2-year period Wiegand submitted more than 10,000
false Medicare claims, then gave a 25% kickback to the patients.64
•
In 2000, the University
of Pennsylvania Health System agreed to pay $12 million to settle
a civil law suit over charges that a medical center had billed
Medicare for psychological counseling and therapy that consisted
of "watching television and attending birthday parties."65
•
In 2001, the Center
for Health and Human Services, Inc. agreed to pay a $500,000 civil
settlement to the Federal Government and the state of Massachusetts
for filing fraudulent Medicare/Medicaid claims for mental health
counseling and substance abuse treatments. It also agreed to plead
guilty to one count of mail fraud in connection with submitting
a fraudulent payment voucher.66
•
The largest health
care fraud suit in America's history involved the smallest sector
of health care—mental health. After the FBI and other federal
agencies raided the offices and facilities of National Medical
Enterprises, the company paid out $1.1 billion in criminal penalties,
fines and to settle suits.
•
Taking a sample
of 400 convictions of mental health practitioners over a five
year period for crimes ranging from drug dealing, sexual abuse
of patients, and fraud, more than $581 million was paid in criminal
fines, restitution and penalties and their combined jail sentences
stretched 2,700 years.
