Superman or Super Liar?

Male hands counting dollars, black salary, money laundering, illegal business, stock footage

Donald McCoy, 54, of Murfreesboro, Tenn., was sentenced for his role in a scheme that led him to plead guilty in January 2020 to healthcare fraud, mail fraud, and money laundering charges. McCoy previously admitted in court to defrauding TennCare, Tennessee’s state-run Medicaid program, out of millions of dollars.

McCoy was a licensed psychologist and an authorized TennCare provider at the time of his fraudulent billing scheme. His area of focus was providing individual psychotherapy and family psychotherapy services. (McCoy will need some therapy sessions of his own after the twisted scheme he instigated.)

The services McCoy provided were normally provided to minors in the care of the Department of Children’s Services (DCS). (He took advantage of a system meant to help troubled youth work through their issues.)  Between January 2014 and December 2018, McCoy fraudulently billed TennCare for services that were never provided, or he exaggerated the number of hours he worked. 

An investigation into McCoy’s suspicious billing practices determined that he regularly submitted claims for psychotherapy services that totaled more than 24, 48, or 72 hours per day. (Unless he’s secretly Superman, this simply isn’t possible.)  

An analysis of McCoy’s timesheets also determined that he billed for services on more than 200 weekends and major holidays that services would not typically be conducted. He claimed he worked on New Year’s Day, the Fourth of July, Thanksgiving and Christmas for several years. (What a dedicated fraudster was he working all of those extra hours to serve vulnerable patients.) McCoy also billed for psychotherapy sessions for patients in DCS custody that were never provided. (It’s probably a good thing that those patients did not receive his advice as it was likely to be twisted anyway.)

The investigation determined that of the more than $2.16 million in claims that McCoy submitted and received payment for, at least $1.2 million were based on fraudulent claims. A judge sentenced McCoy to 41 months in federal prison. He was also ordered to pay $1,217,848.51 in restitution to TennCare. (Fellow prison inmates: beware of any advice that this felon gives out while serving time behind bars. It’s likely to be bad.)

Today’s Fraud of the Day comes from a Department of Justice press release, “Mid-State Psychologist Sentenced To Federal Prison,” dated February 9, 2021.

NASHVILLE, Tenn. – February 9, 2021 – A mid-state psychologist was sentenced today in U.S. District Court to 41 months in federal prison for operating a healthcare fraud scheme, announced U.S. Attorney Don Cochran for the Middle District of Tennessee.

Donald McCoy, 54, of Murfreesboro, Tennessee, was sentenced by U.S. District Judge Eli J. Richardson and ordered to pay $1,217,848.51 in restitution.  McCoy was charged in December 2018 and in January 2020 he pleaded guilty to healthcare fraud, mail fraud and money laundering.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.