Two Austin psychologists and a Cedar Park patient recruiter have been indicted in part of what is now being called the largest health care fraud enforcement action in Department of Justice history.
Attorney General Jeff Sessions and Department of Health and Human Services Secretary Tom Price, M.D., announced the record-breaking health care fraud enforcement action by the Medicare Fraud Strike Force on Thursday.
The Department of Justice said that, in total, 412 defendants were charged across 41 federal districts, including 115 doctors, nurses and other licensed medical professionals for their alleged participation in health care fraud schemes involving an approximated $1.3 billion in false billings.
According to documents obtained from the U.S. Attorney’s Office, an indictment returned by a federal grand jury charged Dr. William Joseph Dubin, 72, and his son Dr. David Fox Dubin, 32, of Austin with one count of conspiracy to violate the federal anti-kickback law; five counts of paying illegal kickbacks; one count of conspiracy to commit health care fraud, seven counts of health care fraud and aiding and abetting health care fraud; and six counts of aggravated identity theft and aiding and abetting aggravated identity theft.
The third local indicted is Glen Elwood McKenzie Jr., 67, of Cedar Park, who is charged with one count of conspiracy to violate the federal anti-kickback law and five counts of receiving illegal kickbacks.
According to the indictment, the Dubins are licensed psychologists who operated Psychological A.R.T.S. in Austin, while McKenzie was the president of the board of directors of an emergency shelter house located about 80 miles from Austin that provided temporary shelter for crisis intervention and mental services to children and youth ages 5 to 17, who had been removed from their homes by the Texas Department of Family and Protective Services.
The indictment alleged that McKenzie used his position at the emergency shelter and his contacts with similar shelters to refer youth to Psychological A.R.T.S. for comprehensive mental health assessments in exchange for kickbacks paid to him.
A release from the Department of Justice said that from January 2011 to June 2015, the Dubins allegedly caused fraudulent billings totaling approximately $300,000 to be submitted to the Texas Medicaid program and the Texas Vocational Rehabilitation Services program for various psychological services. Upon receipt of payment for their services, the release said the doctors paid McKenzie a 10 percent kickback from the money paid to Psychological A.R.T.S.
The indictment alleged that the Dubins also directed unlicensed and unsupervised students and interns to conduct psychiatric diagnostic evaluations of the children and youth referred to them by McKenzie. Those students and interns then allegedly prepared evaluation reports, which included the students’ diagnoses of the psychological condition of each youth, the students’ impression of the risk of each child for future obstructive and disruptive behaviors, and the students’ recommendations for future treatment.
The indictment alleged that the Dubins billed or caused others to send bills to Medicaid that falsely claimed that Dr. William Dubin had done the work that was actually performed by those students and interns. Medicaid rules expressly prohibit psychologists from billing for services performed by students and interns. However, Medicaid rules do allow a psychologist to bill, at a reduced fee, for services provided by supervised licensed psychological associates. That reduced fee is 70 percent of the fee paid for work performed by the licensed psychologist, the Department of Justice reported.
Additionally, the Dubins have been accused of directing unsupervised licensed psychological associates to prepare psychiatric diagnostic evaluations of the children referred to them by McKenzie. According to the press release, the Dubins billed or caused others to bill Medicaid, falsely claiming that Dr. William Dubin had done work that was actually done by the associates, which resulted in a larger payment from Medicaid and a bigger percentage of profit.
If convicted, the Department of Justice said each count related to illegal kickbacks calls for up to five years in federal prison; each count related to Health Care Fraud calls for up to ten years, and each count related to aggravated identity theft calls for up to two years.
