On January 30, 2018, the Office of Inspector General’s Office (OIG) received a hotline report alleging Dr. Katrina Alexander committed abuse, fraud, mismanagement and waste against the VA by purposely lying and manipulating scheduling to receive un-deserved overtime pay, misleading providers, clerks and patients about availability in her schedule. Further, the Psychologist doubled billed for groups, misused the billing codes for psychological testing getting her higher Relative Value Units (RVU), possibly overcharging patients, then allowing her to appear as working more than any other provider. The claimant alleges that this is causing significant access issues for the Mental Health Center (MHC). Additionally, leadership at the facility permitted the Psychologist sole control of her schedule (only Mental Health provider in MHC with this permission) that led to her ability to mask the improper activity, and no action taken by the Texas Veterans Health Care System’s leadership to rectify the alleged improper activity. …show more content…
In FY17, the alleged Psychologist completed 1,300 completed encounters and the results indicated between a 5%-10% higher productivity ratio, which warrants further examination. Additional analysis revealed that the Psychologist used unsupported Current Procedural Terminology (CPT) codes in more than 10 cases reviewed. For example, the Psychologist cited 60 minutes for a psychotherapy appointment plus a file review without a patient present. In another example, the Psychologist cited 60 minutes for a group appointment plus 60 minutes for a psychotherapy appointment, which again appear unsupported with the CPT code
The subjectivity to the mental health process offers has the potential for clinicians to misjudge or misdiagnosis mental disorders if patients. When developing a diagnosis mental health providers should develop a diagnostic system to navigate through the countless descriptors’ and symptoms a client may exhibit to differentiate behavioral, cultural, psychotic, and situational information. Cuthbert and Insel (2013) describes a diagnosis as the most important function for health care providers perform to ensure the true nature of a patient’s aliments are identified in order to serve the optimal medical care. Competent diagnostic interviewers take an investigative approach to their intake to account for all the “polythetic [of] symptoms list[ed]
Client states that he has been experiencing bipolar disorder, anxiety, depression and panics attack for more than three years. Client describe her his anxiety and depression as an isolated feeling, however, he stated that when he feels anxious or depress he speak to his wife. Client also had a bypass surgery in June 2014. Ever send then he had also been struggling with disciplining himself with eating small portions of food. He also stated that he does feel very anxious when he is around a lot of food now in days.
I believe in the case of Mary Bennett she should be getting help in a mental health facility. I do not believe she meant to kill her baby. I believe she suffered from some kind of mental illness. She had a troubled youth and was struggling as a young adult before she had the baby. After she had the baby she struggled to hold on to what she knew was right and what she knew was wrong. And in one of her letters to her boyfriend, she was even speaking of herself in third person. She began to retreat in her early teens, run away, and skip school. She was sent to a group facility for skipping school. Nowhere in her teen years does it say they got her help for the retreating and staying in the basement. No one seems to question then if she might have some kind of depression. I have read in mental health pamphlets giving to me by drug rehab counsels that retreating, hiding away, running away, skipping school, and drinking or drugs can be signs of depression. She had signs of depression, troubled youth and struggled as a young adult, and walked away from her baby, resulting in her death.
Over the course of their therapeutic relationship, Dr. Davenport violates client confidentiality as it is described by the American Counseling
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The Psychological Services at Fresno City provides free services for enrolled college students. These services are individual brief therapy, crisis intervention, group therapy, psychological testing, referral network, consultation, and also provide guest speakers for teachers who want their students to be informed in what is provided on campuses. If or when a student want to have a therapy session the student will be assigned to a therapist. The therapist will then learn from the student on what is going on and how to best help you. The student will receive eight sessions free in the first semester,then after two sessions for the subsequent semesters. Therapy sessions last about 50 mins long and are sequalded once a week. Also therapy is confidential and private. Therapy is a way to help students find different ways to cope, process difficult emotions or situations, and improve the students well-being.
According to the Centers for Medicare and Medicaid Services (CMS), an ACO is "an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.(CMS, 2015).” ACO’s incorporated Chronic Care Management (CCM) Programs to help better oversee patients with multiple chronic conditions who see multiple specialists and allow for better continuity amongst providers caring for the same patient. ACO’s have yet to incorporate mental health services into your CCM program even though one in four primary care patients suffer from a mental disorder.
Medicare fraud can be accomplished in several different ways by medical professional and institutions. In the past, medical professionals in the past have billed Medicare for treatments and equipment that are unnecessary. Overbilling for time not provided in the case of psychiatrists or physical therapists, or services not rendered to the patients at all. Evans and Porche (2005) survey concluded that over 81% of occupational, speech and physical therapists admitted to some form of Medicare fraud. Fraud can be merely cutting sessions short with clients but billing Medicare for the full time allotted or overcharging for their services. Healthcare institutions have admitted individuals when medically unnecessary. Similarly, many hospitals have submitted billing lacking...
Strasburger, L. H., Jorgenson, L., & Sutherland, P. (1992). The prevention of psychotherapist sexual misconduct: avoiding the slippery slope. American Journal of Psychotherapy, 46(4), 544-555.
The report stated “the lack of consistent implementing of scheduling policies, medical staff who schedule appointments were unsure of the correct way to book a patient into an appointment depending on what the patient stated they needed or when being referred the booker was not clear of the type of appointment slot that the patient should be put into due to lack of knowledge of what the referral stated, and several clinics weren’t using the electronic book system. These are the main issues that were seen very quickly during the site visits”, (Draper, 2013). The U.S. Department of Veterans Affairs must make necessary changes in order to provide the health care that the Veterans earned and
Schizophrenia is a chronic DSM- IV axis diagnosis, where the diagnosed is “out of touch” with reality and exhibit bizarre behaviors in relation to the condition. As described in the scenario, paranoia is a common attribute of the condition; triggered by the absence of or ineffective medication therapy or stress.
On March 10, 2015, a social work from University Medical Center (UMC) the Las Vegas Metropolitan Police Department Abuse/Neglect Detail and to the Clark County Public Guardian’s Office stating they had suspected a patient who suffered from early onset dementia had sign a Power of Attorney (POA) and maybe getting taken advantage of by his representative. The social worker explained they had contacted Joanne Filippone, the defendant to make arrangement to place the victim into a long term care facility. The social worker believed the defendant may have been misappropriating the victim’s funds.
Schizophrenia is a serious disorder, which affects how a person thinks, feels and acts. People with schizophrenia will tend to have difficulty distinguishing between imaginary and reality. Roughly 1% of the United State population, or 3 million people, are diagnosed with schizophrenia. There are multiple factors that could cause schizophrenia, such as genetics and environmental. Currently there is no cure, but there is therapy to help manage symptoms.
Cassie* was a client I worked alongside for 8 weeks during my time as student in a community mental health service. Her primary diagnosis at the time was Schizophrenia (Paranoid type) with a secondary diagnosis of Substance (Opioid) Use Disorder. Her case manager reported she has been engaging with the mental health services for two years and was reported to be stable with good insight into her illness at the time of my engagement. My initial role was to collaborate with Cassie to set short and long term recovery goals, and work toward these goals primarily though coaching, educating and advocating. My contact included accompanying Cassie to community groups, doctor’s appointments and facilitating a family meeting.
John, a ten-year-old, normally active child has been feeling ill for about a week. John came down with a dry cough and fever around a week ago, which his parents dismissed as just a simple cold. After taking over the counter medication he was feeling relief the following day. A few days pass, and he began to feel ill once again at school. He was feeling lethargic, had a sore throat, and wasn’t active during recess as usual. His teacher noticed these symptoms and decided to call his parents. His parents picked him up and took him to a nearby urgent care to get checked out. His symptoms were not significant enough to warrant a lab test and the attending physician ruled it as a mild case of the flu. The attending told Johns parents,