Dept of Justice Finds Real Health Care Fraud in Texas

Court roomYesterday the Dallas Morning News reported that a North Dallas psychotherapist plead guilty to a five-year health care fraud scheme and agreed to surrender his license to practice psychology.

The US Attorneys Office press release states that Michael Ellis Wolf, 62, filed claims for payment of services that were never rendered and for services that were rendered in far less quantities than billed.

Billed 7 Days a Week, On Holidays, Sundays, Sometimes for 8 Hours a Day – Over 5 Years
For example, through his billings, Wolf claimed he provided therapy for one particular injured federal employee, from January 2008 through mid-2013, seven days a week, when he in truth and fact he would only provide it once or twice a week, for 60 minutes. He also falsely claimed through billings that he provided therapy to this individual on holidays and on Sundays, and that on multiple days, he provided eight hours of therapy, per day, for this patient. Wolf also falsely claimed, through billings, that he provided four-eight hours of explanations to this patient’s family and employers multiple times a week, when in fact, he only offered occasional phone or in-office consultation with the family.

Paid More than a Million
During this time period, the total amount billed by Wolf, on behalf of this patient, was more than $1.9 million. Of the amount billed, Wolf was paid more than $1 million.

Court records show that ACS (Allied Computer Systems) was the private contractor responsible for overseeing the program and was hired by the federal Office of Worker’s Compensation Plans to serve as the billing administrator for Federal Employee’s Compensation Act. ACS is also the prime contractor of the Texas Medicaid and Health Partnership which controls state Medicaid spending for Texas.

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