Cheyenne Doctor, Wife Plead Guilty To $6.2M Medicaid Fraud
A psychologist and his wife pleaded guilty in federal court on Tuesday to billing Wyoming Medicaid $6.2 million for purported mental health services such as karaoke and shopping, according to court records and a news release from Wyoming U.S. Attorney Mark Klaassen.
Dr. John R. Sink, Jr., and his wife Diane M. Sink each entered pleas to "false statements in relation to health care and aid and abet" before U.S. District Court Judge Alan Johnson in Cheyenne.
In exchange for their pleas, federal prosecutors will dismiss one count of "health care fraud conspiracy" and two counts of "engaging in monetary transactions in criminally derived property and aid and abet" (money laundering) at their sentencings on Dec. 4, according to minutes of the plea hearings.
They are free on bond.
The penalty for making false statements in relation to health care is up to five years in prison, up to a $250,000 fine and up to three years of supervised release, according to the indictment. Restitution, if any, is unknown.
The indictment also lays out the forfeiture procedure for the government to seize the Sinks' property acquired through their illegal activity including funds in financial institutions, a property in Hoodsport, Wash., and vehicles.
John Sink's license expired on June 30, 2017, according to the Wyoming Board of Psychology. The board does not indicate if there have been any disciplinary actions against him.
According to court documents, the Sinks operated a psychological practice, A+ Psychology Solutions, in Cheyenne. Diane Sink was listed as the owner of the practice.
From February 2012 to December 2016, they submitted more than $6.2 million in bills to Wyoming Medicaid for alleged group therapy, but the therapeutic activities did not qualify as group therapy under Medicaid rule. Medicaid is the joint federal-state health insurance program for the poor.
"The Sinks knew their bills contained material false statements because the services provided by the Sinks did not qualify as group therapy, the hours billed did not accurately report the time each Medicaid beneficiary was actively participating in any activities, and the Sinks were not using up-to-date treatment plans to guide each Medicaid beneficiaries treatment as required by Wyoming Medicaid," according to the news release.
For example, the March 15 indictment said the Sinks provided group therapy services including coloring, playing games, singing karaoke, eating at restaurants and shopping.
They billed Wyoming Medicaid about $6,250,589.73, and Wyoming Medicaid reimbursed them $6,247,914.43, according to the indictment.
They also submitted falsely backdated treatment plans when the program audited the their business in May 2016, according to the news release "The Sinks made these false statements knowing that Wyoming Medicaid would not pay for the alleged group therapy if the program knew the true nature of the services being provided by the Sinks, and to conceal their fraudulent billing scheme."
Federal court records do not indicate whether the Sinks through any attorneys filed responses to the indictment.
Klaassen said health care fraud harms everyone through higher taxes and insurance premiums, and the federal government will investigate, prosecute, and punish those who attempt to defraud our health care system.
Special Agent in Charge Calvin Shivers of the Denver Regional Office of the Federal Bureau of Investigation said the guilty pleas serve as a warning to anyone considering engaging in health care fraud.
The FBI and the Wyoming Medicaid Fraud Control Unit investigated this case. Assistant U.S. Attorneys Eric Heimann and Travis Kirchhefer of the Wyoming Medicaid Fraud Control Unit prosecuted it.
If you suspect Medicaid or Medicare fraud, call the U.S. Department of Health and Human Services’ Office of Inspector General at 1-800-447-8477), or the agency’s website.
Wyoming residents can call the Wyoming Medicaid Fraud Control Unit at 1-800-378-0345, or visit their website.