HARTFORD, Conn. — A Glastonbury psychologist who submitted $1.6 million of fraudulent claims to Medicaid between January 2017 and October 2023 was sentenced to prison on Friday, according to a release from the U.S. Attorney for the District of Connecticut.
Michael Pines, 75, of Avon, was sentenced in Hartford to 27 months in prison, followed by three years of supervised release, according to prosecutors, who said he pleaded guilty to health care fraud on Jan. 31.
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Pines owned and operated Michael B. Pines, Ph.D., P.C., in Glastonbury and provided psychotherapy to young children, adolescents, and adults; prosecutors said he was enrolled individually as a Behavioral Health Clinician provider in the Connecticut Medicaid Program.
According to prosecutors, over a period of just under seven years, Pines submitted fraudulent claims to Medicaid for psychotherapy services that he said he provided to his Medicaid clients.
Pines specifically submitted claims for dates of service when no services of any kind had been provided to the Medicaid clients in the claims, including when he was travelling, on vacation, recovering from surgery, or otherwise not working, prosecutors said. He also submitted claims after appointments were cancelled, when a claimed client was in the hospital, when he stopped treating a claimed client, and when he claimed the client had never been his client, according to prosecutors.
Additionally, prosecutors said that when Pines treated multiple Medicaid clients from the same family at the same time, he billed Medicaid for the group visit as multiple individual claims, while knowing the practice was not permitted by Medicaid.
The scheme enabled Pines to defraud Medicaid of $1,617,679, according to prosecutors, who said a U.S. district judge ordered him to pay full restitution; he also handed over 16 pieces of jewelry with an appraised replacement value of $67,685 that he paid for using his business bank account.
Pines is out on a $250,000 bond and is required to report to prison on June 24, prosecutors said.
Those who suspect health care fraud are encouraged to call 1-800-HHS-TIPS.
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Dalton Zbierski is a digital content producer and writer at FOX61 News. He can be reached at dzbierski@FOX61.com.
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