Psychiatrists sometimes try playing God. That's right. Psychiatrists are claiming the ability to perform miracles when treating mental disorders in the elderly. If billing records are to be believed, they are omnipresent – capable of providing services in two rooms at the same time.
Recently, Cleveland psychiatrist Gulshan Sultan agreed to settle out of court with the government for $1.1 million. According to the government, during a five-year period, this one psychiatrist submitted 6,000 false claims to Medicare. Some days, the government alleged, Sultan billed Medicare more than 24 hours a day, demonstrating her remarkable ability to ignore the rules of time as well as space.
Sultan also allegedly billed Medicare for 200 separate days of face-to-face visits during times when no one saw patients. These 200 imaginary visits seem less like miracles and more like hallucinations, but either way Sultan was convicted of criminal misconduct and excluded from participating in the Medicare program. She won't get another chance to perform miracles on Medicare patients.
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Meanwhile, another psychiatrist in New Orleans is alleged to have participated in a different form of fraud on Medicare. The government alleged that Dr. Maria Carmen Palazzo was receiving $144,000 a year in kickbacks from a hospital named Touro Infirmary for referring patients to the hospital. The government claimed that a hospital created a phony consulting contract to make it appear that the psychiatrist was actually performing work to earn the money.
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This psychiatrist was not any more omnipresent than Dr. Gulshan. She could not be in two places at once, and the government alleged that the payments were kickbacks. Medicare rules clearly prohibit paying kickbacks for referrals. The hospital agreed to pay the government $1.75 million to settle the allegations.
The sad truth is that many health care professionals are dishonest in their billings to Medicare. I estimate that as much as 10 percent of Medicare billings are fraud. That amounts to billions of dollars each year. This shortchanges the amount of real health care that can be provided to our elderly.
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If debunking these imaginary miracle workers isn't enough to spur you forward, the government is offering rewards of up to 25 percent of what it collects to those who report it. That amounts to nearly $500,000 as a reward for turning in just one psychiatrist. The reward adds up quickly when the fraud is by a group of professionals, a hospital or a pharmaceutical company.
If you know of someone submitting phony Medicare or Medicaid bills, don't let these fake miracles continue. Step forward.
