June 23, 2005
LICENSED PSYCHIATRIST RECEIVES 18 MONTHS FOR FALSELY
BILLING MEDICAID 1.7 MILLION DOLLARS
Attorney General J. Joseph Curran, Jr., announced today that Dr.
James An Nguyen, 68, of 4300 block of Mary Ridge Drive in Randallstown,
received a sentence of five years, suspending all but 18 months,
after pleading guilty to facilitating the submission of almost
1.7 million dollars worth of false billings to the Medicaid program.
Nguyen is a licensed psychiatrist, and was approved by Medicaid
to bill for therapy services he personally rendered. Medicaid regulations
prohibit a psychiatrist from billing under his own provider number
for services rendered by anyone other than the psychiatrist. According
to Office of the Attorney General prosecutors, in October 2002,
Nguyen entered into an agreement with The Bridges Project, LLC
(“TBP”), which was a provider of unskilled counseling
services to eligible Medicaid recipients, mostly children, in the
Baltimore area. Pursuant to that agreement, from November 2002
until March of 2004, Nguyen allowed TBP to use his individual provider
number to bill for more than 18,000 therapy sessions that he neither
provided nor supervised. Instead, those services were purportedly
provided by mostly unlicensed social workers hired by TBP. In exchange
for improperly allowing the company to use his provider number,
Nguyen received approximately 20% of the amount Medicaid paid for
each therapy session billed under his number by TBP.
As a result of that arrangement, Nguyen received about $340,000
of the $1,699,809 Medicaid paid in response to claims illegally
filed under his provider number, with the rest going to TBP.
As part of his sentence, Baltimore City Circuit Court Judge Wanda
Heard also required Nguyen to pay $305,000 in restitution. Pursuant
to a plea agreement with the State, Nguyen has presented the State
with an initial payment of $100,000 toward that amount. The rest
is to be paid over the five-year period of supervised probation
ordered by Judge Heard.
During its investigation of the relationship between Nguyen and
TBP, the Attorney General’s Office also discovered that for
much of the time that TBP was billing for therapy services using
Nguyen’s number, the company lacked enough therapists to
see all the patients for whom it was billing. At one point, TBP
was billing for weekly therapy services purportedly provided to
as many as 300 children to whom it had not yet even assigned a
therapist. “Although the amount of money stolen from the
State by Dr. Nguyen is startling, what is most upsetting is that
his deception essentially prevented 700 Baltimore City children
from receiving the therapy they needed. Our children deserve better,” said
Attorney General Curran.
The case was prosecuted by the Medicaid Fraud Control Unit (MFCU)
of the Maryland Attorney General’s Office. The MFCU conducted
the investigation with assistance from the Mental Hygiene Administration
(MHA), which suspended payments to Dr. Nguyen in March of 2004.
MHA has been working with the MFCU to root out fraud in its programs,
and several cases of fraudulent behavior by MHA providers have
been successfully prosecuted by the Attorney General’s Office.