Depending on who you speak to, psychologists can be incredibly helpful during a time of need. Mental and emotional stress can be very difficult to deal with if you don’t receive professional help. Over the course of the past few years, the Allegiant Experts Blog has provided takes on a wide variety of stories covering both health care fraud and medical misconduct in North America. But we can’t recall one that involved a psychologist.
Of course, there doesn’t seem to be a sector of the medical world where either fraud or misconduct isn’t taking place. Dr. Arlene Werner has proven that to us. Although the story of her requirement to pay more than $126,000.00 to reimburse the Medicaid program seems like a small deal in comparison to the billions of dollars other fraudsters have racked up, Dr. Werner’s story caught our eye.
Dr. Werner billed Medicaid for services she didn’t provide.
Perhaps, we were holding out some kind of hope that there was a medical practice free from any criminal behavior. Sadly, it would be silly to think so. As Zak Failla of the Fairfield Daily Voice reports, Werner, a licensed psychologist in the State of Connecticut and the owner of a private psychology practice in Waterford, violated the False Claims Act by billing Medicaid for services she failed to provide.
Enrolled as a provider in the Connecticut Medical Assistance Program, which includes the state’s Medicaid program, “Dr. Arlene Werner allegedly billed Medicaid for psychotherapy services that were not provided and for family psychotherapy sessions for multiple family members when she should have instead billed just one member for individual psychotherapy services,” explains Failla.
“Through the Medicaid program, the State of Connecticut provides coverage for mental health and counseling services to citizens who cannot otherwise afford health insurance,” explains the Department of Justice report about this case, “’Behavioral health’ includes a wide variety of health care providers who provide care on an outpatient basis, including psychiatrists, psychologists, licensed clinical social workers, licensed marriage and family therapists, licensed professional counselors, and licensed alcohol and drug counselors”.
Werner paid a total of $126,760.09 to resolve her Medicaid misconduct.
To resolve the allegations against her, Werner has paid a total of $126,760.09 to reimburse the Medicaid program. She is alleged to have submitted false claims to the program from January 2011 through to July 18, 2016. Her agreement to pay the sum has likely gotten her off light. As Failla details, under the False Claims Act, the government has the right to recover up to three times its actual damages, plus penalties of $11,181 to $22,363 for each false claim.
United States Attorney John H. Durham and Connecticut Attorney General George Jepsen made the announcement of Werner’s settlement last week Tuesday. “It is imperative that providers accurately bill Medicaid and other insurance programs,” Durham is quoted as saying, “Working with our federal and state partners, we will continue to protect the integrity of the Medicaid program to ensure its recipients receive the healthcare services they need.”
Are you an attorney trying a case involving health care fraud?
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