ATL doc billed Medicare, Medicaid for dead patients
An Atlanta physician, Dr. Robert J. Williams, pleaded guilty in federal court today to two criminal charges in connection with an alleged $1 million health-care fraud.
Authorities say Williams collected $975,000 from Medicare and Medicaid for group therapy for nursing home patients, much of which was never performed. Many of the patients were deceased when the services were allegedly provided, while others were hospitalized and could not have received the billed services in the nursing home.
In many cases, Williams claimed to have served more than 100 patients in a single day, “although it would have been impossible for him to have provided group psychological therapy to all of those beneficiaries on the same day,” a federal grand jury alleged in a Feb. 22 indictment.
Billings were submitted in the name of Psycho-Therapy Management Services of Georgia, according to the indictment. State records show the company was incorporated in 2008, dissolved in 2008 for failing to file its annual registration, reinstated six months later and dissolved again in 2010.
Here’s today’s news release from the U.S. Attorney’s Office:
DOCTOR PLEADS GUILTY TO BILLING MEDICARE AND MEDICAID
FOR COUNSELING SESSIONS WITH DEAD PATIENTS
Dr. Williams Claimed $2 Million In Phony Health Treatments,
Saying It Was Group Therapy
ATLANTA, GA – ROBERT WILLIAMS, 72, of Atlanta, Georgia, pleaded guilty today in federal district court on two counts of healthcare fraud as part of a scheme to bill for group psychological therapy that WILLIAMS never provided.
United States Attorney Sally Quillian Yates said, “With so many elderly citizens and others who need specialized psychological care, this defendant ignored his duty as a doctor and became a billing machine who claimed to treat patients who were in fact dead. This blatant attempt to rip off the system took funds and care away from real live patients with real problems. Medicare and Medicaid need all the money they can get for legitimate patient care and this physician will get none of that money.”
“This case sends a strong message that Medicare and Medicaid fraud will not be tolerated in Georgia,” said Georgia Attorney General Sam Olens. “At a time when our state budget is heavily strained, every dollar intended for the needy must reach the recipient. We will continue to work with our partners, the U.S. Attorney’s Office and the FBI, to weed out fraud in Georgia.”
Brian D. Lamkin, Special Agent in Charge, FBI Atlanta Field Office, said, “Dr. Williams had for years, enjoyed a position of trust within the medical and health provider industry. He chose to abandon that trust and instead displayed a level of greed that will not be tolerated. Medicare fraud should be promptly reported to the nearest FBI field office so that the much needed federal health care benefits will be there for those individuals who truly need them.”
According to United States Attorney Yates, the charges and other information presented in court: WILLIAMS was a licensed physician, practicing in the Atlanta area. From approximately July 2007 through October 2009, he contracted with a medical services company to provide group psychological therapy to nursing home patients in a variety of nursing homes. Under his signature, thousands of claims were submitted to Medicare and Georgia Medicaid seeking reimbursement for group psychological therapy that WILLIAMS purportedly provided to beneficiaries at several nursing homes in the Atlanta area. In many instances, however, WILLIAMS did not actually provide the therapy.
Specifically, from July 2007 through October 2009, Medicare claims data indicated that over 55,000 claims were submitted using WILLIAMS’ provider number for group psychological therapy. Those claims sought reimbursement for over $2,000,000, and ultimately caused Medicare to reimburse WILLIAMS over $750,000. For the same time period, over 40,000 Medicaid claims were submitted by WILLIAMS for group psychological therapy, causing Georgia Medicaid to pay out over $225,000.
An investigation of WILLIAMS’ claims showed that, in many cases, he sought payment for services provided to beneficiaries who were deceased at the time he purportedly rendered the care. In two cases, the patient died over a year before he was allegedly seen by WILLIAMS in the nursing home. Numerous claims were submitted to Medicare and Medicaid for group psychological therapy when the beneficiary was hospitalized at the time of service and, consequently, could not have received care at the nursing home as represented.
WILLIAMS was indicted on February 22, 2011 on 10 counts of health care fraud. Today WILLIAMS pleaded guilty to two of those counts. He could receive a maximum sentence of ten years in prison and a fine of up to $250,000 for each count. In determining the actual sentence, the Court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.
Sentencing has been scheduled for August 23, 2011, at 11:30 a.m. before United States District Judge Richard W. Story.
This case is being investigated by Special Agents of the Federal Bureau of Investigation and the Georgia Medicaid Fraud Control Unit.
Assistant United States Attorneys Kurt R. Erskine and Nick Oldham, and Senior Assistant Attorney General Nancy Alstrom from the Georgia Medicaid Fraud Control Unit, are prosecuting the case.