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The July/August 1995 issue of the John Cooke Fraud Report, an industry publication of fraud investigators, noted that anyone who believed psychiatry would never dare to hospitalize people who were not sick to begin with in order to milk their insurance dry was “dead wrong.”

The report stated, “Fraud in psychiatry is alive and well and apparent in the delivery of every area of mental health and substance abuse treatment around the country.”

Many new examples of psychiatric fraud have proven the statement to be only too true. One instance involved a psychiatrist who bilked another psychiatrist’s insurance company to treat the “Post Traumatic Stress Disorder” his colleague supposedly acquired after a minor fender-bender.

In another case, a Georgia psychiatrist, James E. McClendon, reduced his Medicaid billings for treatment of children and adolescents from $6.6 million in 1994 to $6.1 million in 1995. Those billings caught the attention of the Georgia Department of Medical Assistance (DMA), which investigated and found he had billed out an average of 488 hours of therapy a week.

Fraud: Alive and well in the psychiatric industry

piechart
of the $411 Million paid in Health-care related fines in 1994 $375 Million Were paid by psychiatric Hospitals.

In one four-year period, the number of psychiatric institutions doubled.

OUTBREAK OF “MENTAL ILLNESS”: After medical coverage expanded in April 1992, many children suddenly became “mentally ill” and wound up in psychiatric institutions. After measures went into effect in 1993 to clamp down on fraud, the mysterious “outbreak” disappeared.



Psychiatry’s $40,000,000,000 Fraud continued...

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