CCHR Seeks Public Input on Psychotropic Drug Billing and Psychiatric Abuse: Applauds Congressmen for Behavioral Hospitals Investigation Call

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Mental health watchdog Citizens Commission on Human Rights announces that it is expanding its review of facilities belonging to the nation’s largest behavioral healthcare system, Universal Health Services (UHS) and that it is seeking public input on psychiatric drug billing, financial and psychiatric patient abuse. CCHR applauds Congressmen Joe Kennedy III (D-MA) and Danny Davis (D-IL) for writing to the Dept. of Health and Human Services requesting the federal agency speed up its investigation into UHS.

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To date, CCHR has documented numerous complaints about UHS facilities, including unlawful and damaging use of restraints (even on young children), restraint deaths, and teenagers and other patients being violently handled.

The Citizens Commission on Human Rights (CCHR) applauds Congressmen Joe Kennedy III (D-MA) and Danny Davis (D-IL) for writing to the Department of Health and Human Services (HHS), requesting the federal agency speed up its investigation into the nation’s largest behavioral healthcare system, Universal Health Services (UHS).[1] CCHR is expanding its seven-year review of UHS facilities and is seeking further information from employees, patients, family members or friends of those who allege psychotropic drug billing and financial and patient abuse in such psychiatric and behavioral facilities that bill Medicaid, Medicare or other healthcare insurance companies.

In March, UHS headquarters in Pennsylvania was added to a multi-federal agency investigation by the Department of Justice (DOJ) and Office of the Inspector General (OIG) of the Department of Health and Human Services looking into 21 of its psychiatric facilities.[2] Among the more than 195 UHS psychiatric and behavioral centers, $3.7 billion in revenue is generated annually.[3]

The UHS filing to the Securities and Exchange Commission, states: “In February, 2013, the OIG served a subpoena requesting various documents from January, 2008 to the date of the subpoena directed at Universal Health Services, Inc….” A DOJ investigation is also focusing on UHS billing. In late March, 2015, the UHS reported: “We were notified that the investigation conducted by the Criminal Frauds Section [of the DoJ] has been expanded to include UHS as a corporate entity arising out of the coordinated investigation….”[2]

CCHR has documented numerous complaints about private psychiatric facilities, including unlawful and damaging use of restraints (even on young children), restraint deaths, and teenagers and other patients being so violently handled that one patient's arm was broken and another required a lower-leg amputation. There are also ample reports of excessive doses and heavy reliance on psychiatric drugs— antidepressants, antipsychotics, stimulants and sedative-hypnotics—which can be billed to Medicaid, Medicare and other insurance plans.

Former 11-year U.S. Department of Health and Human Services Inspector General, Richard Kusserow, acknowledged that "many health care fraud investigators believe mental health caregivers, such as psychiatrists and psychologists, have the worst fraud record of all medical disciplines."[4]

As part of its investigation into prescribing and billing practices, CCHR found:

  • One psychiatrist working at a behavioral center in Florida between 2009-2013, wrote 5,819 prescriptions in 2012—three times greater than the average of 1,801 prescriptions for all psychiatrists in Florida. This same psychiatrist billed $140,000 to Medicare for procedures and services in 2012, which is $93,654 more than the average for Florida psychiatrists. And, between 2009-2014, the psychiatrist received $278,795 from pharmaceutical companies that manufacture psychotropic drugs.[5]
  • Another Florida psychiatrist billed Medicare $891,371, receiving Medicare reimbursement to the tune of $367,023—a whopping $339,838 more than the average for Florida psychiatrists.[6]
  • Four psychiatrists at Dallas, Texas, psychiatric center billed Medicare $666,836 for services in 2012 with Medicare reimbursing more than $314,290. One psychiatrist accounted for $184,000, which was $166,166 more than the average psychiatrist's Medicare payment in Texas.[7]

The abuse in the mental health system is not limited to the federal Medicare system. A June 2015 report released by the Medicaid and CHIP Payment and Access Commission (MACPAC) reports "the high rates of psychotropic medication use in the Medicaid population, risks associated with these drugs, and research documenting inappropriate prescribing, have raised concerns, especially for children involved in the child welfare system and older adults with dementia."[8]

About 14% of Medicaid beneficiaries used a psychotropic drug during calendar year 2011, at a cost of nearly $8 billion in fee-for-service for psychotropic drugs— 30% of the program's total fee-for-service drug spending.[8]

While the financial cost of psychiatric fraud is being revealed, there are much more disturbing data. For example, of a sample of some 533 psychiatrists and psychologists convicted of crimes reported to CCHR, fraud accounted for 36% (191) of the total convictions, followed by patient sexual abuse (30%) and drug-related crimes (13%). The Federal Bureau of Investigation (FBI) has declared that "rooting out healthcare fraud is central to the well-being of both our citizens and overall economy."[9]

Based on the data so far collected, psychiatric financial and patient abuse is rampant. CCHR believes first-hand accounts of these psychiatric abuses are necessary to better understand the depth of the injury and is counting on public participation to expose the egregious harm currently being perpetrated and safeguard against future abuse.

Read the full article here.

About Citizens Commission on Human Rights: CCHR is a non-profit, non-political, non-religious mental health watchdog. Its mission is to eradicate abuses committed under the guise of mental health and enact patient and consumer protections. CCHR has helped to enact more than 150 laws protecting individuals from abusive or coercive mental health practices.

References:

[1] Letter to Acting Administrator, Center for Medicare and Medicaid Services, Dept. of Health and Human Services, from Members of Congress Joseph P. Kennedy, III and Danny Davis, June 23, 2015, kennedy.house.gov/sites/kennedy.house.gov/files/06.23.15.UHS%20Letter.pdf; David Jackson and Gary Marx, "Lawmakers urge faster action to protect youths at residential treatment sites," Chicago Tribune, June 23, 2015, chicagotribune.com/news/watchdog/rtc/ct-psychiatric-provider-investigation-watchdog-met-20150623-story.html.
[2] UHS Inc, SEC Filing, For 8K, 31 Mar. 2015, Item 7:01, Regulation FD Disclosure, sec.gov/Archives/edgar/data/352915/000119312515113094/d898400d8k.htm; “UHS posts strong quarter even as it faces federal probe,” Phily.com, April 30, 2015,
articles.philly.com/2015-04-30/business/61657494_1_steve-filton-uhs-strong-quarter
[3] “UHS posts strong quarter even as it faces federal probe,” Phily.com,30 Apr. 2015,
articles.philly.com/2015-04-30/business/61657494_1_steve-filton-uhs-strong-quarter; “An investor’s guide to Universal Health Services’ service mix,” Market Realist, January 1, 2015, marketrealist.com/2015/01/investors-guide-universal-health-services-service-mix/.
[4] Richard P. Kusserow, “Mental Health Ranks High on Fraud Scale,” Walters Kluwer, September 23, 2014, health.wolterskluwerlb.com/2014/09/kusserows-corner-mental-health-ranks-high-on-fraud-scale/.
[5] Physician and Other Supplier Data CY 2012, “Anjali Anil Pathak,” Centers for Medicare & Medicaid Services, cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier2012.html.
[6] Physician and Other Supplier Data CY 2012, “Sanjeev Singh,” Centers for Medicare & Medicaid Services, cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier2012.html.
[7] Physician and Other Supplier Data CY 2012, “Ruth Anne Mardock, Kochuparampil Varghese, Scott Robert Bartley and Ronnie Pollard,” Centers for Medicare & Medicaid Services, cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Medicare-Provider-Charge-Data/Physician-and-Other-Supplier2012.html.
[8] “Use of Psychotropic Medications among Medicaid Beneficiaries,” The Medicaid and CHIP Payment and Access Commission, macpac.gov/wp-content/uploads/2015/06/Use-of-Psychotropic-Medications-among-Medicaid-Beneficiaries.pdf.
[9] “Health Care Fraud,” Federal Bureau of Investigations, fbi.gov/about-us/investigate/white_collar/health-care-fraud.

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