Workers' compensation fraud is often associated with employeesfeigning or exaggerating injuries; however, a growing number of medicalproviders and employers are bilking the system. While someproviders bill for services never rendered, others may employunlicensed staff to pad profits.

One case in point is Dr. Joseph T. Spare, a Marion, Ohiopsychiatrist who billed for a suspiciously high volume ofcounseling and medication management sessions compared to hispeers. The Ohio Bureau of Workers' Compensation (BWC) noticed thediscrepancy and launched a formal investigation.

Although the bureau received bills indicating Spareperformed both services for each session, the SpecialInvestigations Department's Healthcare Provider Fraud Team foundthe counseling sessions were actually executed by three of hisstaff members at Marion Independent Physicians Association (MIPA).Furthermore, the MIPA employees hosting the sessions were notlicensed to provide counseling. In actuality, Spare merely checkedthe patients' medication at the end of these counselingsessions.

The matter was settled outside of court after the Ohio AttorneyGeneral's Office filed a civil suit in Marion County Common PleasCourt. The suit named Spare and MIPA defendants and determined theBWC was fraudulently billed a total of about $74,700.

Spare agreed to pay the BWC $150,000 to cover the overpaymentand investigative costs.

Investigators concluded that between January 2004 and August2007, Spare billed the BWC for more than 1,100 psychotherapysessions conducted by three under-qualified employees. As a resultof using these improperly licensed staff to perform counselingservices, Spare's office was able to see a high numberof patients per day, generating more revenue than it wasentitled to receive.

“When people think of workers' compensation fraud, they oftenpicture injured workers,” says BWC Administrator/CEO Steve Buehrer.“However, workers' compensation fraud can and does includeemployers and providers. We're committed to bringing anyone whocommits fraudulent activity to justice.”

It is currently unclear if the settlement willjeopardize Spare's licensure in the state of Ohio.