Natick Psychiatrist Indicted for Billing Medicare and Private Insurance Companies for Services Never Rendered and for Obstruction
BOSTON – A Natick psychiatrist was arrested today in connection with charges that he billed Medicare and private insurance companies for over $10 million in treatments he did not provide and then obstructed justice in an attempt to conceal his crimes.
Gustavo Kinrys, 49, of Wellesley, was indicted on seven counts of wire fraud, six counts of false statements relating to health care matters, one count of falsification of documents and one count of obstructing a criminal health care investigation. Kinrys was arrested today and will appear via videoconference in federal court in Boston this afternoon.
“Fraud in the Medicare system is a persistent, long-term problem,” said United States Attorney Andrew E. Lelling. “Physicians who defraud the system are taking dollars that could otherwise be used to support patient health. We will continue to prioritize these cases.”
“We take very seriously our responsibility to safeguard taxpayer funds by eliminating fraud within our federal healthcare system,” said Phillip M. Coyne, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “Today’s arrest and the charges alleged in the indictment serve as a strong reminder that we will not tolerate fraud against our federal healthcare system or acts of obstruction that attempt to conceal those schemes.”
“Dr. Kinrys is accused of exploiting our healthcare system—paid for, in part, by taxpayer dollars—in order to line his own pockets without any regard for the harm his actions would cause. He billed public and private insurance companies more than $10.6 million for medical treatments he never provided, and then tried to cover it up by obstructing the investigation,” said Joseph R. Bonavolonta, Special Agent in Charge of the FBI Boston Division. “Anyone involved in, or entertaining similar activity should know that health care fraud is a priority for the FBI, and we will pursue anyone trying to steal from this country’s vital health care system.”
“This case illustrates the commitment of all agencies to combat medical billing fraud which affects all citizens. The Insurance Fraud Bureau of Massachusetts places a high priority on fighting this type of insurance fraud. We applaud the collaboration of our investigative partners in combating fraud in our healthcare system,” said Anthony M. DiPaolo, Executive Director of the Massachusetts Insurance Fraud Bureau.
Kinrys was a licensed psychiatrist who owned and operated Advanced TMS Associates, located in Natick, Mass. Among other services, Kinrys offered transcranial magnetic stimulation (TMS) therapy and psychotherapy to patients suffering from depression. TMS therapy is a noninvasive method of brain stimulation that uses rapidly alternating or pulsed magnetic fields to induce electrical currents directed at a patient’s cerebral cortex.
The indictment alleges that between January 2015 and December 2018, Kinrys engaged in a variety of fraudulent billing schemes in which he sought and received reimbursement for services he did not render. For example, Kinrys billed Medicare and private insurers over $10 million for thousands of TMS sessions he never provided, including over 8,000 sessions he claimed were provided to 75 patients who, in fact, never received a single session of the therapy. Kinrys allegedly billed Medicare and private insurers for hundreds of thousands of dollars’ worth of psychotherapy sessions he never provided, including over 1,000 face-to-face sessions he falsely claimed he provided while he or his patients were in fact out of the country. On hundreds of occasions, it is alleged that Kinrys billed Medicare and private insurers for having provided more than 24 hours’ worth of psychotherapy services in a single day, including one day in 2017 when he claimed he had provided hour-long psychotherapy sessions to 79 different patients.
To further his fraudulent billing scheme, Kinrys allegedly made numerous false statements to his patients, the billing company with which he worked and the insurers to whom he submitted claims seeking reimbursement. When Medicare, private insurers, and the Department of Health and Human Services (HHS) sought records from Kinrys pertaining to certain of his claims, he took steps to conceal his fraudulent conduct by making false representations and creating false documentation purporting to show that he had provided thousands of treatments he had billed for, but never rendered. For example, in response to a July 2018 subpoena from the HHS’s Office of Inspector General seeking medical records for 10 of his patients, Kinrys allegedly created documents – and ordered his office workers to create documents – falsely stating that those patients had received dozens of treatments they had never been provided.
The charges of wire fraud and destruction or falsification of records each provide for a sentence of up to 20 years in prison, three years of supervised release and a fine of $250,000 or twice the gross gain or loss, whichever is greater. The charges of false statements relating to health care matters and obstruction of a criminal investigation of a health care offense each provide for a sentence of up to five years in prison, three years of supervised release and a fine of $250,000 or twice the gross gain or loss, whichever is greater. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and other statutory factors.
U.S. Attorney Lelling, HHS-OIG SAC Coyne, FBI Boston SAC Bonavolonta and Massachusetts IFB Executive Director DiPaolo made the announcement today. Assistant U.S. Attorney Patrick Callahan of Lelling’s Health Care Fraud Unit is prosecuting the case.
The details contained in the indictment are allegations. The defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.