FWA (AR)- doctor’s Medicaid billing suspended after fraud allegations


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[MM Curator Summary]: A doc in Arkansas appears to not be doing much at all.




Clipped from: https://www.nwahomepage.com/news/nwa-doctors-medicaid-billing-suspended-after-fraud-allegations/


FAYETTEVILLE, Ark. (KNWA/KFTA) — A Northwest Arkansas psychiatrist has had his Medicaid billing privileges suspended following allegations of fraud.

According to a letter from the Arkansas Office of Medicaid Inspector General Elizabeth Smith, Dr. Brian T. Hyatt of Rogers was informed of the suspension on February 24. It stated that the decision was made to suspend “all payments for Medicaid services” performed by Hyatt after the office received a “credible allegation of fraud.”

The suspension does not pertain to other individual members of the group provider “Brian T. Hyatt, MD, PLLC dba Pinnacle Premier Psychiatry,” but it added that no payments will be made to Hyatt’s provider number during the suspension.

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“This suspension is temporary and will continue until either the investigation authority determines there is insufficient evidence of fraud, or the legal proceedings related to the alleged fraud are completed,” it noted.

The letter added that illegal participation in the Arkansas Medicaid Program is a class A misdemeanor punishable by up to one year in jail and a fine of up to $2,500. Hyatt has the right to appeal the suspension within 30 calendar days of receiving notice.

Hyatt was named the medical director of the behavioral unit at Northwest Medical Center in Springdale in 2018 and worked there until he was “abruptly terminated” in May, 2022, according to court documents. The Medicaid Control Fraud Unit was contacted by a whistleblower and confidential informant (CI) who worked in that unit and indicated that Hyatt was only on that employee’s floor “a few minutes each day” and that the doctor had “no contact with patients.”

“The CI described him walking up and down the hall with a computer on wheels and never entering the rooms or meeting with patients. The CI said Dr. Hyatt did not want the patients to know his name and that he directed staff to mark through his name on the armbands of patients.”

Probable cause statement, Medicaid Fraud Investigator, January 17

The informant also provided investigators of a photo of a posted sign instructing staff to cross out his name on patient armbands, according to court documents. The CI believed that Hyatt was “fraudulently billing Medicaid, Medicare, and other health insurance companies.”

A probable cause report filed as part of the investigation noted that “some of the patients were being held against their will” and noted that “only a physician could make the decision to impose a 72-hour hold” under Arkansas law. It added that any false statement made in a claim that resulted in an overpayment of $2,500 or more is a felony offense.

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That filing continued by stating that the fraud investigators obtained approximately two months of surveillance video from the behavioral unit at the Northwest Medical Center. Agents “have reviewed several days and hundreds of hours of video and have yet to observe Dr. Hyatt enter a patient’s room or otherwise have direct contact with a patient.”

“Sometimes he pauses at the rooms and may even look in,” it stated. “But he does not enter the room or have patients come out into the hall.” It went on to explain that the use of data analytics “identified several red flags,” and noted that Hyatt “is a clear outlier, and his claims are so high they skew the averages on certain codes for the entire Medicaid program in Arkansas.”

In January, investigators were granted a search warrant to obtain data from Hyatt’s cell phone through his wireless provider.