Chevy Chase Social Worker Pleads Guilty To Health Care Fraud
Agrees to Pay $444,600 in Criminal Restitution and Civil Penalties
Greenbelt, Maryland - Melvin Shandler, age 61, of Chevy Chase, Maryland, pleaded guilty today to committing 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.
According to the plea agreement, Shandler was a licensed clinical social worker with a private counseling practice in Chevy Chase, Maryland. He was also 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.
Shandler faces a maximum sentence of 10 years in prison, followed by three years of supervised release and a $250,000 fine. U.S. District Judge Roger W. Titus has scheduled sentencing for July 28, 2008 at 2:00 p.m. As part of his plea agreement, Shandler has agreed to pay $247,000 in restitution at least five days before his sentencing. Shandler has 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.
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 are prosecuting the case.