Philadelphia Psychiatrist to Pay $3M to Resolve Allegations

Philadelphia Psychiatrist to Pay $3 Million to Resolve Allegations of False Workers’ Compensation Claims

(STL.News) United States Attorney Jennifer Arbittier Williams announced that Dr. Harry Doyle and his wife, Sonya Doyle, of Philadelphia, PA, have agreed to pay a total of $3 million to resolve alleged violations of the False Claims Act. The alleged violations include submitting false billing to the U.S. Department of Labor Office of Worker’s Compensation Programs (OWCP) for psychiatric services that were not provided, as well as upcoding and double-billing patient claims.  As part of the settlement, the Doyles have also agreed to be voluntarily excluded from federal healthcare programs for a period of 25 years.  This is the largest recovery against a single psychiatrist in the history of the OWCP.

Dr. Doyle was a psychiatrist to whom an attorney referred patients receiving federal workers’ compensation benefits authorized under the Federal Employees Compensation Act. Many of his patients received OWCP benefits because of a physical injury, and then were later approved for mental health services that were purportedly needed because of the initial physical injury. Dr. Doyle’s wife, Sonya Doyle, was his office assistant, and the sole employee of Dr. Doyle’s mental health practice.

A multi-agency investigation of Dr. Doyle’s practice revealed that from January 2013 through April 2021, the Doyles allegedly billed for services not rendered, some of which occurred when the Doyles were not physically present in the United States. The Doyles allegedly billed for cancelled and no-show appointments as if they had actually occurred, “upcoded” or billed for a higher level of service than what was actually provided including billing for more therapy time than spent with the patient, and also double-billed the patient and OWCP for initial consultations. Dr. Doyle allegedly falsified treatment records to reflect the false billing that was submitted.

“Our resolution of this matter and the significant recovery we have obtained from this physician show once again that no matter how complex the fraud scheme is, we will find it, stop it, and punish it,” said U.S. Attorney Williams. “The alleged falsified documentation Dr. Doyle created and submitted to OWCP compromised the agency’s ability to monitor claimant care and ensure that injured federal workers received the services they needed.”

“Dr. Harry Doyle and his wife Sonya Doyle entered into a settlement agreement to resolve alleged violations of the False Claims Act. The alleged violations involve the submission of potentially fraudulent billing to the U.S. Department of Labor Office of Workers’ Compensation Programs (OWCP) by Dr. Doyle’s practice. Today’s significant monetary settlement of $3 million and agreement to voluntary exclusion from federal healthcare programs for a period of 25 years will serve as a deterrent to those contemplating committing fraudulent billing schemes. The U.S. Department of Labor, Office of Inspector General will continue working with our law enforcement partners and OWCP to protect the integrity of DOL’s benefits programs,” stated Special Agent-In-Charge Syreeta Scott, Philadelphia Region, U. S. Department of Labor Office of Inspector General.”

“Abuse of OWCP will not be tolerated and is a drain on the United States Postal Service’s finances,” said Imari R. Niles, Executive Special Agent in Charge of the U.S. Postal Service Office of the Inspector General. “USPS OIG is dedicated to investigating and eradicating this type of conduct.”

“Fraudulent healthcare billing practices compromise the federal government’s ability to provide quality benefits to deserving individuals,” said Special Agent in Charge Christopher Algieri of the Department of Veterans Affairs Office of Inspector General’s Northeast Field Office.  “The VA OIG is pleased to have worked together with its law enforcement partners to stop this couple from continuing their fraudulent practices.”

This case was investigated by the Department of Labor Office of Inspector General, the United States Postal Service Office of Inspector General, and Department of Veterans Affairs Office of Inspector General. For the U.S. Attorney’s Office, the investigation and settlement were handled by Assistant United States Attorney Viveca D. Parker and Auditor Dawn Wiggins.

The civil claims resolved by this settlement are allegations only and there has been no determination of liability.

SOURCE: USDOJ.Today