Welcome to the
Fraud of the Day Website!

Upcoded

hand holding American dollar currency isolated on blurred blackground injured woman with broken hand and green cast on arm, insurance health concept.
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Dr. Harry Doyle of Philadelphia, Penn., and his wife, Sonya Doyle entered into a hefty settlement agreement to resolve various allegations of false workers’ compensation claims.

Dr. Doyle was a psychiatrist to whom an attorney referred patients receiving federal workers’ compensation benefits authorized under the Federal Employees Compensation Act. Sonya Doyle, Harry’s wife, was his office assistant, and the sole employee of Dr. Doyle’s practice. (What a convenient setup to carry out a fraudulent billing scheme.)

Many of Dr. Doyle’s patients originally received U.S. Department of Labor Office of Worker’s Compensation Programs (OWCP) benefits because of a physical injury. They were later approved for mental health services that were allegedly needed because of the initial physical injury.

From January 2013 to April 2021, Dr. Doyle and his wife allegedly billed for services that were never provided. (Some occurred when the Doyles may have been vacationing).

The Doyles had a slew of false billing instances. They allegedly billed for cancelled and no-show appointments and “upcoded” services, sometimes even double-billing OWCP and patients. Dr. Doyle allegedly falsified treatment records to reflect these false billing submissions. The alleged violations include submitting false billing to the OWCP.

The Doyles entered into a settlement agreement to resolve alleged violations of the False Claims Act. (Let’s hope this will prompt them to rethink any future fraudulent activity.) These violations involve the submission of potentially fraudulent billing to OWCP by Dr. Doyle’s practice. They agreed to voluntary exclusion from federal healthcare programs for a period of 25 years and settled for a whopping $3 million. This is the largest recovery against a single psychiatrist in the history of the OWCP and one that hopefully serves as a deterrent against future fraudulent billing schemes.

Today’s Fraud of the Day comes from a Department of Justice press release, “Philadelphia Psychiatrist to Pay $3 Million to Resolve Allegations of False Workers’ Compensation Claims,” dated March 28, 2022.

PHILADELPHIA – United States Attorney Jennifer Arbittier Williams announced that Dr. Harry Doyle and his wife, Sonya Doyle, of Philadelphia, PA, have agreed to pay a total of $3 million to resolve alleged violations of the False Claims Act. The alleged violations include submitting false billing to the U.S. Department of Labor Office of Worker’s Compensation Programs (OWCP) for psychiatric services that were not provided, as well as upcoding and double-billing patient claims. As part of the settlement, the Doyles have also agreed to be voluntarily excluded from federal healthcare programs for a period of 25 years. This is the largest recovery against a single psychiatrist in the history of the OWCP.

Dr. Doyle was a psychiatrist to whom an attorney referred patients receiving federal workers’ compensation benefits authorized under the Federal Employees Compensation Act. Many of his patients received OWCP benefits because of a physical injury, and then were later approved for mental health services that were purportedly needed because of the initial physical injury. Dr. Doyle’s wife, Sonya Doyle, was his office assistant, and the sole employee of Dr. Doyle’s mental health practice.

Related Articles

Get Your Fraud Fix!

Five days a week wake up to the most current fraud article in your inbox

Contact Us

Thank you for your interest in Fraud of the Day. For more information, please complete the following form.
To receive the most current fraud articles direct to your inbox, click the Subscribe button above.

"*" indicates required fields

Hidden
Would you like to subscribe to our Blog?
We respect your privacy.
This field is for validation purposes and should be left unchanged.

SUBSCRIBE TODAY

Fill out the form below to receive the Daily Fraud Highlight, the Weekly Fraud Summary or both. Thank you for your interest in FraudoftheDay.com.

"*" indicates required fields

Name*
Subscription Type*
This field is for validation purposes and should be left unchanged.