Former Arkansas Medical Board chairman arrested on felony fraud charges - Insurance News | InsuranceNewsNet

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October 10, 2023 Newswires
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Former Arkansas Medical Board chairman arrested on felony fraud charges

Arkansas Times (Composite Blogs)

Dr. Brian Hyatt, the former chairman of the Arkansas State Medical Board, was arrested Monday on a warrant related to felony Medicaid fraud charges.

Hyatt resigned from the board earlier this year in the face of ongoing state and federal investigations and his suspension from Medicaid.

A warrant issued Monday repeats many, but also adds to the, allegations against the Northwest Arkansas psychiatrist that were first made public in an Advocate investigation in February.

In an affidavit, an investigator from the Arkansas attorney general's office accuses Hyatt of devising a scheme to bill Medicaid and other health insurance providers for psychiatric care that was never provided while he was running the behavioral health unit at Northwest Medical Center in Springdale.

"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 for a level of care that the patients at the [behavioral health unit] were not receiving," the affidavit states. "Security footage, eyewitness statements from patients and eyewitness statements from former employees of NWMC provide clear evidence that Dr. Hyatt was not treating patients at the level expected to bill for CPT code 99233."

Arkansas Attorney General Tim Griffin said late Monday afternoon Hyatt was arrested by the Rogers Police Department and will make his first appearance in Pulaski County circuit court later this month.

Hyatt and several of his attorneys didn't respond to requests for comment on the pair of fraud charges.

Hyatt resigned as chairman of the State Medical Board a day after the Advocate revealed the suspect billing practices and ongoing state reviews. He resigned from the board altogether in May.

In his resignation letter, Hyatt said he would defend himself from the "false allegations" against him in the proper forum.

Northwest Medical Center's parent company agreed to pay a $1.1 million settlement to the state in the fallout around Hyatt.

Then-Attorney General Leslie Rutledge's office began investigating Hyatt last year after receiving a complaint from a whistleblower who worked at Northwest Medical Center.

Investigators pieced together suspicions of improper billing practices through interviews with patients, staff and Hyatt himself. They also examined numerous billing and medical records.

But the most damning evidence came from their review of thousands of hours of surveillance footage from the hospital and tracking Hyatt's movements during the 46-day period from March 15, 2022 to April 29, 2022, which investigators concluded showed that Hyatt had made false statements to them during an interview.

Investigators determined that Hyatt was present in the unit just 24 of the 46 days. On the days he was present, the affidavit states he spent an average of less than two hours at the hospital and 70% of that time was in his office.

Of the time spent on patient floors, he mostly rolled a computer cart down the hallways, rarely entering patients' rooms or talking with them face to face, the investigator wrote.

"The total time Dr. Hyatt was seen talking to patients or was in their rooms was less than 10 minutes out of a total of 2,671 minutes (.37%)," the affidavit said.

"That means Dr. Hyatt spent .37% of his time on the unit interacting with patients who were supposedly receiving a daily detailed interval history and daily detailed examination, which required medical decision making of high complexity."

When investigators interviewed several of Hyatt's patients, the patients said that they never saw Hyatt nor did they know who he was.

Despite this, Hyatt was billing for the highest level of care at rates well in excess of similar psychiatrists in the state, records show.

Staff members also told investigators that they felt pressured to describe patients as "suicidal" even when they felt the patients weren't having suicidal ideations because Medicaid would be less likely to deny the claims.

Hyatt's patient progress notes — which investigators noted were highly templated — also threatened insurers and medical reviewers with legal action if they disagreed with his manner of care, according to the affidavit.

During the first four months of last year, Hyatt billed various state medical programs for more than $251,500 in psychiatric care, and the false claims exceeded $25,000, the threshold for a Class A felony, according to court records.

It isn't clear how or if the state charges affect the federal investigation into Hyatt.

In addition to the criminal case and administrative review of his Medicaid license, Hyatt is also a defendant in a growing number of civil suits filed by former patients. The several dozen plaintiffs have accused Hyatt of fraud,

The most recent lawsuit was filed last week.

Arkansas Advocate is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Arkansas Advocate maintains editorial independence. Contact Editor Sonny Albarado for questions: [email protected]. Follow Arkansas Advocate on Facebook and Twitter.

The post Former Arkansas Medical Board chairman arrested on felony fraud charges appeared first on Arkansas Times.

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