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Case Number: 3:19-cr-00003-1
Judge: Eli J. Richardson
Court: United States District Court for the Middle District of Tennessee (Davidson County)
Plaintiff's Attorney: United States District Attorney’s Office
Description: Nashville, Tennessee health care fraud charge criminal defense lawyer represented Defendant, Donald McCoy, 54, of Murfreesboro, Tennessee, who was charged with 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.
Indictment 1/09/2019: 18:1347(1), 18:1347(2), and 18:2 Health care fraud
Superseding Indictment 5/22/2019: 18:1347(1), 18:1347(2), and 18:2 Health care fraud
Indictment 1/09/2019: 18:1341 and 18:2 Mail fraud
Superseding Indictment 5/22/2019: 18:1341 and 18:2 Mail fraud
Indictment 1/09/2019: 18:1028A(a)(1) and 18:2 Aggravated identity theft
Superseding Indictment 5/22/2019: 18:1028A(a)(1) and 18:2 Aggravated identity theft
Superseding Indictment 5/22/19: 18:1957 and 18:2 Engaging in monetary transactions in property derived from specified unlawful activity
Superseding Indictment 5/22/19: 18:1956(a)(1)(B)(ii) and 18:2 Money laundering
Outcome: Defendant was sentenced to 42 months in prison and was ordered to pay $1,217,848.51 in restitution.
02/11/2021 94 REDACTION by Donald Martin McCoy to 88 Order on Motion for Leave to File Sentencing Document Under Seal,, (Wooten, Mariah) (Entered: 02/11/2021)