NASHVILLE, Tenn. – February 9, 2021 – A mid-state psychologist was sentenced today in U.S. District Court to 41 months in federal prison for operating a healthcare fraud scheme, announced U.S. Attorney Don Cochran for the Middle District of Tennessee.
Donald McCoy, 54, of Murfreesboro, Tennessee, was sentenced by U.S. District Judge Eli J. Richardson and ordered to pay $1,217,848.51 in restitution. McCoy was charged in December 2018 and in January 2020 he pleaded guilty to healthcare fraud, mail fraud and money laundering.
During the scheme, McCoy was a licensed psychologist by the State of Tennessee and was an authorized TennCare provider who provides individual psychotherapy and family psychotherapy services to patients—usually minors—in the care of the Department of Children’s Services (“DCS”). Between January 2014 and December 2018, McCoy billed for more hours of services than can physically be provided in any given day and received over $2.16 million from TennCare based on those claims.
An investigative analysis conducted by the Tennessee Bureau of Investigation determined that on multiple occasions, McCoy submitted claims for psychotherapy services that totaled more than 24 hours per day, some even exceeding 48 hours and 72 hours per day. The analysis also determined that McCoy billed for services purportedly rendered on more than 200 weekends and major holidays, including New Year’s Day, the Fourth of July, Thanksgiving and Christmas, among others. On numerous occasions, McCoy billed for family psychotherapy sessions involving patients in DCS custody, which never occurred.
The investigation determined that of the more than $2.16 million in claims submitted to TennCare by McCoy, at least $1.2 million which he received payment for was based on fraudulent claims.
This case was investigated by the Tennessee Bureau of Investigation; the U.S. Postal Inspection Service; and the IRS Criminal Investigation. Assistant U.S. Attorneys Kathryn Booth and Sarah Bogni are prosecuting the case.