Health Care, Human Resources, and Law

Psychologist pleads guilty to health care fraud

June 23, 2017
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A psychologist has pled guilty to felony health care fraud for billing insurers for counseling sessions he did not provide.

Acting U.S. Attorney Andrew Byerly Birge said yesterday that George E. Compton Jr., 63, of Sturgis, pled guilty in the scheme that ran from at least Jan. 1, 2013 until June 30, 2016.

Compton will be sentenced by the court at a future date. He will face a maximum prison term of 10 years and a fine of up to twice the amount of the gross gain from his fraud. He will be ordered to make restitution to his victims.

“Today’s guilty plea should serve as a warning that those who place their own greed for profits above honest billing practices will be identified and prosecuted,” said David Gelios, special agent in charge, Detroit Division of the FBI.

According to court records, Compton defrauded health care benefit programs of at least $250,000. He established relationships with numerous patients, provided periodic counseling sessions to them and billed their health insurers.

After gaining new patients, Compton regularly billed their insurance for counseling sessions that far exceeded the number of counseling sessions he in fact provided.

When his patients or the health insurers occasionally detected his excess billings, he said he had made an honest mistake or the automated billing software had failed, and he reimbursed the health care benefit programs for the overpayment.

When audited by one of the insurance companies, Compton provided fake patient counseling notes in an attempt to make it appear as if he provided counseling sessions on dates he knew he had previously submitted false billing.

On at least one occasion, he billed for counseling sessions he claimed occurred at his Coldwater office, although he was in Pittsburgh at the time.

Another time, he billed for counseling sessions for a patient who was in an induced coma at the hospital and later homebound.

“Unfortunately, this case represents yet another example of how some health care professionals allow their own greed to lead them down the path of defrauding health care benefit programs and ultimately harming consumers of health insurance,” Birge said.

“My office will continue to vigorously prosecute those who commit health care fraud against private or public health insurance plans.”

The case was investigated by the Kalamazoo office of the FBI and is being prosecuted by Assistant U.S. Attorney Ronald Stella.

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