CHEVY CHASE SOCIAL WORKER SENTENCED FOR HEALTH CARE FRAUD

Jul 29, 2008 (JUSTICE DEPARTMENT DOCUMENTS AND PUBLICATIONS/ContentWorks via COMTEX) -- ZZATN | Quote | Chart | News | PowerRating -- July 28, 2008

CHEVY CHASE SOCIAL WORKER SENTENCED FOR HEALTH CARE FRAUD

Agrees to Pay $444,600 in Criminal Restitution and Civil Penalties

Greenbelt, Maryland - U.S. District Judge Roger W. Titus sentenced Melvin Shandler, age 61, of Chevy Chase, Maryland, today to 24 months in prison, followed by two years of supervised release, for health care fraud arising out of reimbursement he sought for medical services not rendered, announced United States Attorney for the District of Maryland Rod J. Rosenstein. As specified in his plea agreement, Shandler has already paid $247,000 in restitution. Shandler also signed a civil settlement agreement which obligates him to pay the government $444,600, less the deduction for the amount paid in criminal restitution. In addition to incarceration, supervised release and restitution, Judge Titus fined Shandler $10,000.

According to his plea agreement, Shandler was a licensed clinical social worker with a private counseling practice in Chevy Chase, Maryland. He was formerly employed as a consultant at the Walter Reed Army Medical Center where he practiced social work. From June 2003 to May 2007, Shandler submitted claims to TRICARE, a U.S. Department of Defense health care benefit program, for counseling services he provided to TRICARE members. During a review of claims, TRICARE auditors detected an unusually high amount of claims submitted by Shandler. For example, in the TRICARE North Region in 2006, Shandler billed 250% more services than the second highest billing provider. At their peak, Shandler's billings averaged up to 24 counseling sessions per day, and he billed for services on Labor Day, Independence Day and Christmas Day.

Further investigation revealed that Shandler's claims were disproportionately high, either because he requested compensation for services that were never performed, or inflated the amount of time he spent with patients. For example, in the case of one family, he submitted claims for 202 services during a one year period from 2006 to 2007 that he never performed. As a result of his overbilling, Shandler received $247,000 to which he was not entitled.

United States Attorney Rod J. Rosenstein thanked the Defense Criminal Investigative Service for its investigative work and recognized TRICARE Management Activity and the Walter Reed Army Medical Center for their cooperation and assistance in this investigation. Mr. Rosenstein commended Assistant United States Attorneys Jonathan C. Su and Tarra DeShields, who prosecuted the case.

CONTACT AUSA VICKIE E. LEDUC or

http://www.usdoj.gov/usao/md

MARCIA MURPHY at (410) 209-4885

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