Workers' compensation fraud is often associated with employees feigning or exaggerating injuries; however, a growing number of medical providers and employers are bilking the system. While some providers bill for services never rendered, others may employ unlicensed staff to pad profits.

One case in point is Dr. Joseph T. Spare, a Marion, Ohio psychiatrist who billed for a suspiciously high volume of counseling and medication management sessions compared to his peers. The Ohio Bureau of Workers' Compensation (BWC) noticed the discrepancy and launched a formal investigation.

Although the bureau received bills indicating Spare performed both services for each session, the Special Investigations Department's Healthcare Provider Fraud Team found the counseling sessions were actually executed by three of his staff members at Marion Independent Physicians Association (MIPA). Furthermore, the MIPA employees hosting the sessions were not licensed to provide counseling. In actuality, Spare merely checked the patients' medication at the end of these counseling sessions.

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

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

Investigators concluded that between January 2004 and August 2007, Spare billed the BWC for more than 1,100 psychotherapy sessions conducted by three under-qualified employees. As a result of using these improperly licensed staff to perform counseling services, Spare's office was able to see a high number of patients per day, generating more revenue than it was entitled to receive.

“When people think of workers' compensation fraud, they often picture injured workers,” says BWC Administrator/CEO Steve Buehrer. “However, workers' compensation fraud can and does include employers and providers. We're committed to bringing anyone who commits fraudulent activity to justice.”

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

Special Reports /

Ohio Psychotherapist Bilked Workers&rsquo; Comp of $74,700; Settles Out of Court

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Ohio Psychotherapist Bilked Workers’ Comp of $74,700; Settles Out of Court