The US Department of Justice’s Office of Justice Programs states, “Government rosters of physicians suspended from Medicare and Medicaid programs due to fraud and abuse indicate that psychiatrists represent a disproportionately large segment of the total.” Correct. “Mental health counselors” regularly rip off American taxpayers in outrageous ways, for example by claiming money—often very big money—for services they never delivered. To wit: Three Connecticut “substance abuse counselors” were just caught red-handed stealing huge sums from Medicaid for allegedly providing counseling to patients—“counseling” that never happened. It was all very slick—until it wasn’t. The three “counselors” apparently were more proficient at fraud than they were at anything else. One imaginatively named business, Miracles to Destiny, was merely a fancy marketing front for a Medicaid scam operation that did nothing for patients, while delivering a ton of profit to the scammers. Thelma “Wendy” Epps, 59, a Licensed Alcohol and Drug Abuse Counselor (LADC), set up scams with two licensed Connecticut Medicaid providers, Dennis Tomczak and Shawn Tyson, to use their Medicaid authorization to submit bills for hundreds of thousands of dollars in mental health counseling services that were never performed. After Epps and her company were suspended from Medicaid for suspected fraud, she used Tomczak’s Medicaid provider number to fraudulently bill for services. When Tomczak got nervous about the scope of the scam they were running, Epps brought Tyson into the scheme. A Department of Justice press release states, “At some point during their scheme, Tomczak expressed concerns to Epps about the number and frequency of services that Epps told Tomczak she was providing. At about this time, Epps entered into a similar agreement with Shawn Tyson, a LADC in Connecticut, whereby Tyson would use his Medicaid provider number to submit claims to Medicaid for services Epps purportedly provided to Medicaid clients.” It was all very slick—until it wasn’t. Epps was fined a whopping $1,001,058 and is looking at a possible 10-year prison sentence in January. Some $20 billion of fraud originates in the mental health industry. Tomczak and Tyson both pled guilty and are awaiting sentencing. Tyson provided the names of patients and dates they were supposedly counseled on, and Epps would submit the cases for Medicaid billing. She had an arrangement with Tomczak to pay him a 25 percent kickback. The scam brought in at least $330,547 for Tomczak. Tomczak made $7,879 alone for, in effect, renting out his Medicaid billing number. Tyson? He pulled down an estimated $663,081. Not bad, eh? At least, until you get caught. In another case, Lorena Soto-Bunker, 49, who owned the Where Healing Begins Wellness Center, was given a two-year suspended prison sentence and five years of conditional discharge, during which she cannot serve as a Medicaid provider after posing as a licensed behavioral health therapist. Which she wasn’t. When the unlicensed Soto-Bunker worked for Collaborative Counseling Center, a company owned by Alicia Thompkins, it was Thompkins who billed Medicaid for $19,786 for therapy that was never performed. Thompkins was also convicted and fined $140,000. The fraud schemes conducted by these Connecticut scam artists were significant, but constitute a tiny fraction of the staggering $100 billion that taxpayers lose every year to health care fraud. Some $20 billion of fraud originates in the mental health industry, with psychiatrists shown to have the worst record of all when it comes to fraudulent billing. Mark Schiller, president of the American Association of Physicians and Surgeons, admitted: “I have frequently seen psychiatrists diagnose patients with a range of psychiatric diagnoses that aren’t justified, to obtain [insurance] reimbursements.” It’s no wonder that Richard Kusserow, who served for 11 years as the US Department of Health and Human Services inspector general, said, “Many health care fraud investigators believe mental health caregivers, such as psychiatrists and psychologists, have the worst fraud record of all medical disciplines.” Effective counseling relies on trust. Tell me, how can you trust a scam artist? |
“Mental Health” Counselors Continue to Rip Off American Taxpayers
Twenty billion in annual fraud originates in the mental health industry. In the latest embarrassment, three Connecticut counselors were caught red-handed.
