LITTLE ROCK -- The Arkansas Attorney General's Office filed formal Medicaid fraud charges against a Rogers doctor in Pulaski County Circuit Court on Wednesday, according to a news release.
"Today a special prosecutor in my office filed two counts of Medicaid fraud, a Class A felony, against Dr. Brian Hyatt," Attorney General Tim Griffin said in the release.
The charges stem from claims between Jan. 1 and April 29, 2022, at Northwest Medical Center-Springdale, during which time Hyatt made fraudulent Medicaid claims in excess of $300,000, Griffin said.
Class A felonies are punishable by six to 30 years in prison and up to $15,000 in fines, he said.
Hyatt, 49, was arrested pursuant to a warrant Oct. 9 in Rogers, then appeared in Pulaski County District Court on Oct. 19, where he surrendered his passport and signed an extradition waiver before being released on a $15,000 bond.
"Today's filings constitute formal charges being brought in this case," Griffin said in the release.
An affidavit used to secure an arrest warrant for Hyatt said the doctor billed Medicaid for high levels of care but seldom actually treated patients.
The affidavit filed by Gregory McKay, a senior special agent for the Medicaid Fraud Unit of the Arkansas Attorney General's Office, said security footage and statements from eyewitnesses and former employees of Northwest Medical Center's Behavioral Health Unit provide clear evidence Hyatt wasn't treating patients at the level required to justify his billing to Medicaid.
"From January 1, 2022, until April 29, 2022, Dr. Brian Hyatt and the staff that he trained and supervised submitted false Medicaid claims on Dr. Hyatt's behalf," the affidavit states.
McKay concluded based on Medicaid guidelines, the therapy services shouldn't have been billed by Hyatt.
Former employees told investigators they received little or no training from Hyatt, according to the affidavit. They also said they were directed to bill for the highest levels of service, which paid Hyatt the most money.
A confidential informant told investigators Hyatt was only present in the unit for short periods on the days he was scheduled to work, had little to no contact with patients and spent the time he was in the unit walking up and down the halls pushing a computer on wheels.
Griffin announced in March that Northwest Arkansas Hospitals agreed to pay the state more than $1 million in connection with 246 Medicaid claims based on medical evaluations, diagnoses and supporting documents certified by Hyatt and nonphysician providers working under his control and supervision.
That settlement came after an audit by a state contractor, the Arkansas Foundation for Medical Care, found documentation provided for the claims "did not justify or support the medical necessity requirement for hospitalizations," Griffin said in a news release announcing the settlement.
The Office of Medicaid Inspector General suspended all payments for Medicaid services to Hyatt, according to a Feb. 24 letter the Northwest Arkansas Democrat-Gazette obtained under the Arkansas Freedom of Information Act. The office determined there was a "credible allegation of fraud" against Hyatt.
Hyatt had been the unit's medical director since January 2018. His contract with the medical center was "abruptly terminated" in May 2022, the affidavit states.
He stepped down as chairman of the Arkansas State Medical Board in March but kept his seat on the board until he resigned in May. He denied being involved in any wrongdoing in his letter of resignation.
Hyatt has been the center of investigations by both state and federal authorities this year.
Medicare and Medicaid Fraud
Medicare and Medicaid fraud refer to illegal practices aimed at getting unfairly high payouts from government-funded health care programs. Fraud involves deceit with the intention to illegally or unethically gain at the expense of another, in this case in order to illegally gain at the expense of government-sponsored health care programs.
Source: investopedia.com