Marion doctor to repay $150,000 for fraudulent workers’ comp bills
MARION – A Marion psychiatrist agreed to repay the Ohio Bureau of Workers’ Compensation (BWC) for improperly billing the agency for more than 1,100 psychotherapy sessions conducted by under-qualified staff members. Dr. Joseph Spare and the Marion Independent Physicians Association (MIPA), of which Spare is a member, agreed to repay BWC $150,000 to cover the overpayment and investigative costs.
“Dr. Spare billed the BWC for a much higher number of services than his peers, and we took notice of that,” said BWC Administrator/CEO Steve Buehrer. “When people think of workers’ compensation fraud, they often picture injured workers. However, workers’ compensation fraud can and does include employers and providers. We’re committed to bringing anyone who commits fraudulent activity to justice.”
The BWC’s Intelligence Unit detected that Spare was billing for a large number of counseling and medication management sessions. BWC received bills indicating Spare performed both services for each session, but the Special Investigations Department’s Healthcare Provider Fraud Team found the counseling sessions were actually being performed by three of his staff members, MIPA employees who weren’t licensed to provide counseling. Dr. Spare was only checking the patients’ medication at the end of their counseling sessions.
The three under qualified MIPA personnel conducted more than 1,100 psychotherapy sessions between January 2004 and August 2007. As a result of using these improperly-licensed staff to perform counseling services, Spare’s office was able to see more patients per day, generating more revenue than it was entitled to receive.
The matter was settled outside of court after the Ohio Attorney General’s Office filed a civil suit in Marion County Common Pleas Court; Spare and MIPA were named as defendants. BWC was fraudulently billed a total of $74,667.68. Reimbursements for the services Spare rendered were paid to MIPA.
To report suspected workers’ compensation fraud, call 1-800-OHIOBWC, visit ohiobwc.com, or visit http://www.facebook.com/ohiobwcfraud.