Colorado Springs Doctor Agrees To Pay Over $85,000 To Settle Allegations That He Improperly Billed TRICARE
DENVER – A Colorado Springs doctor has agreed to pay $86,675.68 to settle allegations that he inappropriately billed TRICARE, the United States military health insurance program, the U.S. Attorney’s Office for the District of Colorado and the Defense Criminal Investigative Service announced. The U.S. District Court for the District of Colorado also entered a consent judgment against the doctor, David Hatfield, age 48, and his company, DBH. As part of the terms of the settlement Dr. Hatfield has to pay $1,400 per month.
TRICARE is the United States military health insurance program. It pays for, among other things, therapy services to developmentally disabled children who are children of military members. While TRICARE pays for this type of therapy, it does not pay for administrative services.
Dr. Hatfield provided therapy services to developmentally disabled children. The United States alleged that from 2008 through 2013, Dr. Hatfield and DBH also improperly submitted hundreds of claims to the TRICARE program for administrative services. In particular, Dr. Hatfield and DBH improperly collected substantial payments from TRICARE on claims for such things as time spent filling out timesheets, time spent for cancelled appointments where no therapy was provided, or time or money spent on supplies or food.
Dr. Hatfield and DBH have agreed to pay the United States $86,675.68 to resolve these allegations. Dr. Hatfield and DBH further agreed to the entry of a consent judgment against them in the amount of $1,283,027.04 based on this conduct. If Dr. Hatfield does not make the payments based on the settlement agreement, the government can enforce the consent judgment, which would result in Dr. Hatfield having to pay the entire amount of the judgment.
“Healthcare providers can only bill the government for the healthcare services they provide,” said U.S. Attorney John Walsh. “When they charge the government for money not owed to them, such as administrative services in this case, they can and will be held responsible for that conduct.”
“Dr. Hatfield and Developmental Behavioral Health, Inc., overbilled the TRICARE program that provides health care for our military warfighters, their families, and military retirees,” said Janice M. Flores, Special Agent in Charge of the Defense Criminal Investigative Service (DCIS) Southwest Field Office, Arlington, Texas. “If health care providers want to be paid for their services with taxpayer dollars, they have to play by the rules. Americans deserve to know that they are getting their money’s worth. This settlement highlights the Federal Government's continuing resolve to ensure those who defraud the Department of Defense, and ultimately the American taxpayers, are held accountable for their actions.”
This matter was investigated by the Defense Criminal Investigative Service. The Defense Health Agency, Office of Program Integrity, provided significant assistance. It was handled by Assistant U.S. Attorneys Marcy Cook and Zeyen Wu.