Was Rhett E. McCarty the hardest-working licensed psychologist in the state of Missouri?
It sure seemed so, judging from his billings to Medicare and Medicaid.
Between the middle of September 2008 and April 2012, he billed the federal health care programs for every day of the calendar year, including all weekends and holidays, except Christmas, according to federal court records. And many of those workdays at his practice in Lebanon, Mo., were 17 hours long.
But federal prosecutors alleged Friday that the 67-year-old Lake Ozark, Mo., resident defrauded the government out of almost $1.3 million meant to pay for legitimate mental health care for the poor and elderly.
Authorities also moved to keep McCarty in jail before trial, saying they were afraid he would try to persuade his patients not to testify against him. As it is, some of his female patients have alleged to both state and federal authorities that McCarty engaged in “misconduct of a sexual nature” with them, according to federal court records.
One patient purportedly told investigators that her therapy visits — paid for with federal health care funds — “were really of a sexual nature.”
“(McCarty) also included another patient in at least one of the sexual encounters,” according to a prosecution motion asking for detention. “In addition, (McCarty) had engaged in a sexual relationship with the patient’s mother.”
Another patient told investigators that she had many sexual encounters with McCarty, for which she was paid in telephone calling cards and up to $40 in cash.
Assistant U.S. Attorney Lucinda S. Woolery said that in jail McCarty would not be able to bully his patients, whom she described as “low-income, disabled, elderly, uneducated or otherwise at risk.”
“(McCarty) poses a serious risk to vulnerable patients,” Woolery wrote.
McCarty appeared in federal court Friday — his birthday — and a judge ordered him to wait in jail until a lawyer appears with him at a formal detention hearing next week.
The indictment focused on in-home psychotherapy services that McCarty allegedly billed for 19 patients. While prosecutors acknowledged that he did offer some services to those patients, none reported receiving care at anything like the frenetic pace McCarty described in his billing records.
Each of the 19 said McCarty never provided him or her with services on a daily or near-daily basis, Woolery wrote.
“Two of the beneficiaries saw the defendant only once, yet he billed for daily or near-daily services,” Woolery wrote.
One patient was out of town visiting relatives for two months last year, but McCarty billed for daily services, the indictment alleged.
McCarty’s billings, according to court records, showed he billed the federal government for providing 173 consecutive days of psychotherapy care to one patient in 2009 and 2010. But when investigators asked about those sessions, the patient reported seeing McCarty only once during that time and did not recognize his photograph, prosecutors alleged.
Woolery alleged that McCarty bought his patients’ participation in the scheme by giving them gifts, such as cash, food, cigarettes, a toilet for a trailer, an air conditioner and telephone calling cards.
He also helped them manage their Medicaid benefits so they could remain eligible for the program and continue to see their physicians and get prescriptions.
Court records show that in addition to the federal criminal indictment, which alleges health care fraud and forgery, McCarty is facing state disciplinary action for billing fraud and allegedly having inappropriate relations with patients.