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hand holding American dollar currency isolated on blurred blackground injured woman with broken hand and green cast on arm, insurance health concept.

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.

 

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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.