Michael B. Pines, a 75-year-old Glastonbury psychologist, has been sentenced to 27 months in prison for defrauding Medicaid of more than $1.6 million. Pines, who owned and operated Michael B. Pines, Ph.D., P.C., in Glastonbury, submitted fraudulent claims to Medicaid for psychotherapy services that were not provided to his clients.
According to court documents, between January 2017 and October 2023, Pines submitted claims for dates of service when no services were provided, including when he was traveling, on vacation, or recovering from surgery. He also submitted claims for canceled appointments, hospitalizations, and terminated clients. Furthermore, Pines billed Medicaid for group visits as individual claims, a practice not permitted by Medicaid.
The investigation revealed that Pines used his business bank account for personal expenditures, including purchasing 16 pieces of jewelry with an appraised value of $67,685. Through this scheme, Pines defrauded Medicaid of $1,617,679.
U.S. District Judge Sarala V. Nagala ordered Pines to make full restitution and forfeit the jewelry. Pines pleaded guilty to healthcare fraud on January 31, 2024, and was released on a $250,000 bond. He is required to report to prison on June 24.
The investigation was conducted by the U.S. Department of Health and Human Services, Office of the Inspector General (HHS-OIG) and the Federal Bureau of Investigation. The case was prosecuted by Assistant U.S. Attorney David T. Huang.
As the Grimy Times continues to expose healthcare scams, we urge the public to remain vigilant and report any suspicious activity. If you suspect healthcare fraud, call 1-800-HHS-TIPS or visit the website to report it anonymously. In this case, Pines’ greed led to a hefty price, serving as a warning to others who would seek to exploit the system.
RELATED: Glastonbury Psychologist Sentenced for $1.6M Medicaid Scam
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Key Facts
- State: Connecticut
- Agency: DOJ USAO
- Category: White Collar Crime
- Source: Official Source ↗
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