Charles Fredrick McCusker, Health Care and Mail Fraud, Salt Lake Ci…

GRIMY TIMES EXCLUSIVE: Charles Fredrick McCusker, a 62-year-old licensed psychologist from Salt Lake City, has been charged with health care fraud and mail fraud by a federal grand jury. The indictment, returned Wednesday, alleges that McCusker bilked federal and private benefit programs out of over $1.3 million for services he never provided to patients between 2007 and August 2013.

The 18 counts of health care fraud and 16 counts of mail fraud stem from a multi-agency investigation involving the FBI, the U.S. Health and Human Services’ Office of Inspector General, the Utah Insurance Fraud Division, the Utah Attorney General’s Office, and the U.S. Attorney’s Office. This indictment follows a previous state felony information filed in February 2014, which accused McCusker of identity fraud, insurance fraud, and a pattern of unlawful conduct.

Operating under the names Health Balance International and New Life Balance, McCusker is accused of billing private insurers and government health care programs for services he never rendered to patients. He reportedly obtained health insurance information from patients under the pretense that he would bill only for actual services provided. However, the indictment claims McCusker failed to meet with some patients or provide follow-up services, yet still fraudulently billed their healthcare programs.

In addition to billing for non-existent services, McCusker is alleged to have provided services on several occasions and then fraudulently billed for additional services not rendered. The fraudulent claims were processed and paid by health care benefit programs.

A summons has been issued for McCusker to appear in federal court, where he faces a potential maximum penalty of 10 years for each count of health care fraud and 20 years for each mail fraud count. It is important to note that an indictment is not a determination of guilt; the defendant is presumed innocent until proven guilty.