November 1st, 2014

Sisters accused of improper billing

Twin sisters are accused of billing public agencies in Massachusetts hundreds of thousands of dollars for unlicensed psychological services, often using stolen identities, according to Attorney General Martha Coakley.

Nita Guzman and Nina Tischer, 49, formerly of Burlington, pleaded not guilty in September to charges of Medicaid false claims, false claims to public agencies, larceny, identity fraud and unlicensed practice of psychology, according to a news release from the Attorney General’s office.

Guzman, through her company New England Psychological Consultants, Inc., is accused of billing Medicaid, Medicare and Lawrence Public Schools more than $550,000 for unlicensed mental health services, according to the release. Tischer, through her company PsychSupport, Inc., is accused of billing a division of UMass Medical School more than $30,000 for unlicensed psychological examinations. Guzman and Tischer, who were living in Minnesota at the time of the indictment, are not licensed psychologists, which is a legal requirement to practice in Massachusetts.

“Through their corporations, both located in Lowell, the sisters provided bilingual psychological services to Medicaid and Medicare members in the greater-Lowell and greater-Lawrence areas, performed mental health disability evaluations for the Department of Transitional Assistance and the state’s Medicaid program (MassHealth), and assessed children for learning disabilities for the Lawrence Public Schools,” says the release.

An investigation into the sisters began when licensed professionals contacted the AG’s Office about the misuse of their name and licensing information. A licensed psychologist who provided Guzman her name and license information during a job discussion contacted the AG’s Office to report that her information had been used without permission to bill a Medicaid managed care organization more than $430,000, according to the office.

Further investigation showed Guzman had used another psychologist’s name and license information to bill the managed care organization and the federal Medicare program more than $60,000 in services that were not provided by the psychologist.

Guzman is also accused of billing Lawrence Public School system for more than $60,000 in psychological evaluations of students in special education programs, evaluations that were performed by Guzman or Tischer. “The sisters did cognitive evals for patients that were not receiving ongoing care,” says the AG’s Office in an email. “So really, the sisters were only performing one-time evals. It’s hard for us to say if some patients went on to receive ongoing care from licensed professionals or not but it wasn’t a circumstance for us to be concerned about that.”

A licensed social worker reported the unauthorized use of her name and license information by Tischer’s company, PsychSupport, to bill a division of UMass Medical School more than $8,000 for disability examinations, according to the AG’s Office. Two other professionals reported the similar unauthorized use of their names and license information by Tischer to bill UMass more than $30,000 for disability evaluations.

The AG’s Office says the pair faces significant penalties if convicted, but did not specify what penalties.

This type of case is unusual. “There are similar cases to this but rarely do they involve actually using someone else’s identity or providing services while not licensed,” according to the AG’s Office.

The office says psychologists should be cautious about providing name and license information. Agencies can check if a professional is licensed through a search of the Mass. Board of Registration. Several requests by New England Psychologist to speak with a board representative were denied because the case is still pending.

By Rivkela Brodsky

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