Head Games

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When someone plays head games in a relationship, he or she is clearly acting dishonestly with the intent to cause confusion. This can be disorienting, especially if one person in the relationship trusts the other person to look out for his or her best interests. In a similar manner, patients trust that their doctors have their best interests at heart. Patients are counting on their physicians to provide a treatment plan that ensures they are on the road to recovery. The website Examiner.com reports on a licensed Brooklyn psychiatrist, who took advantage of his Medicare patients and billed the government benefits program for home medical treatment that never occurred.

The story states that the 55-year-old doctor, who was employed by the U. S. Department of Veterans Affairs (VA), also operated a private practice out of his residence while not on duty at the VA. According to court records, over a six-and-a-half year period, the doctor submitted fraudulent claims to the Medicare program for more than $4 million in home medical visits that supposedly occurred while he was away on vacation in China or during the time patients were confined to a hospital. The ”head doctor” received more than $2.8 million in Medicare payments from the scheme. (And, as you can guess, this fraudster did not provide treatment for the majority of his patients – many of whom were elderly Medicare recipients and veterans who justly deserved the benefit.)

The psychiatrist pleaded guilty to defrauding the federal health care system and faces a maximum sentence of 10 years in prison. (It’s probably a given that he will also lose his medical license.)

The VA provides benefits and services that support service members, veterans and their dependents and survivors. These folks have more than paid their dues by risking their lives to protect our country. They deserve the benefits that the VA provides, and it is an injustice when greedy criminals take advantage of the system. Thankfully, this doctor was headed off by the Health and Human Services Administration’s Office of the Inspector General and the Medicare Strike Force – and now he will face a few head games of his own while while serving out his sentence.

Source: Today’s ”Fraud of the Day” is based on the article titled, ”Psychiatrist Pleads Guilty to Defrauding Government Health Care System,” published on Examiner.com on October 31, 2013.

NEW YORK – On Wednesday, the same day that Secretary of Health and Human Services Kathleen Sebelius testified before a congressional panel about ”glitches” in the new Obamacare web site, and her boss President Barack Obama visited Boston, Mass., to boast about the benefits of government-run medical insurance, a physician working for a government agency pleaded guilty in a Brooklyn, N.Y., courtroom to defrauding the federal health care system.

A licensed psychiatrist, Dr. Mikhail L. Presman, working for the U.S. Department of Veterans Affairs (VA), pleaded guilty to health care fraud. He admitted that he falsely billed Medicare for home medical treatment to Medicare beneficiaries and he agreed to forfeit more than $1.2 million in illegal profits.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.