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Athens Psychologist Sentenced To Prison Term For Billing Medicaid For Therapy Sessions That Were Never Performed

PRESS ADVISORY

Athens Psychologist Sentenced To Prison Term For Billing Medicaid For Therapy Sessions That Were Never Performed

January 28, 2010

Paul D. Mangum, 62, an Athens, Georgia psychologist, was sentenced today by United States District Judge William S. Duffey, Jr. to serve two years in federal prison on a charge of health care fraud.

Georgia Attorney General Thurbert Baker said, “Fraud committed by mental health treatment providers in Georgia's Medicaid program serves to victimize both the taxpayers as well as those individuals needing additional mental health treatment.  My office will continue to work closely with our federal and state partners to ensure that those who target our Medicaid program are themselves the targets of criminal prosecution.”

Acting United States Attorney Sally Quillian Yates said of the case, “This defendant lied to Medicaid by fabricating treatment records and submitting false claims.  In doing so, he stole over a half million dollars from the Medicaid system that was designed to provide services for the needy in our communities.  He has now been called to account for his actions.”

Mangum was sentenced to two years in prison to be followed by three years of supervised release, and ordered to pay restitution in the amount of $558,086.  Mangum pled guilty to a Criminal Information charging him with health care fraud on September 8, 2009.

According to Baker and Yates, the charges and other information presented in court:  Between May 2003 and April 2009, Mangum, a licensed psychologist in Athens, Georgia, submitted thousands of fraudulent claims to the State of Georgia Medicaid program for psychological therapy sessions that never took place.  As part of his scheme to defraud, Mangum submitted claims for patients who had previously received treatment from Mangum but who had stopped treatment, sometimes years before.  For example, Mangum saw one child once a week for only a few months, but then submitted over 100 fraudulent claims for the patient over a period of more than five years, receiving thousands of dollars in Medicaid payments for therapy sessions he never performed.  Mangum also submitted false claims for the younger sibling of one of his patients, even though the sibling never saw Mangum. 

To carry out his fraud, Mangum fabricated patient notes in the files and kept two sets of appointment books, one in which he recorded legitimate appointments and another, maintained for billing purposes, in which he added names to be billed fraudulently.  The investigation revealed that Mangum submitted over $550,000 in fraudulent claims to the Medicaid program over a five-year period.

Senior Assistant Attorney General Scott Smeal with Georgia's Health Care Fraud Control Unit and Assistant United States Attorney Stephen McClain prosecuted the case.  This case was investigated by the Program Integrity section of the Georgia Department of Community Health and the Georgia Health Care Fraud Control Unit, which consists of prosecutors from the Georgia Attorney General’s Office, investigators with the Georgia Bureau of Investigation, and auditors with the Georgia Department of Audits and Accounts.