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    Monday, June 24, 2024

    Psychologist gets prison for $1.6M in phony Medicaid billing; money used for lavish lifestyle

    A well-known Connecticut child psychologist was sentenced to two years and three months in prison Friday for stealing $1.67 million in one of the biggest state Medicaid frauds in memory.

    Dr. Michael B. Pines, who practiced in Glastonbury and lives in Avon, was accused of overbilling Medicaid by collecting on tens of thousands of phony claims for psychotherapy services over nearly seven years.

    Federal prosecutors said Pines spent the money on nearly $100,000 in jewelry; travel to Saint Maarten, Dublin, Amsterdam, Barcelona, Prague, Athens, Santorini, Cancun, Montreal, Ottawa, Cape Town, Zimbabwe, and Bangkok; and nearly $160,000 on an allowance and mortgage payments for his adult son in Florida.

    In a filing with the federal court, Pines, who specialized in “attachment disorder” in children and teens, said he consulted with a colleague in an effort to understand why he “clearly violated his own personal high standards, as well as the law.”

    The conclusion is that Pines, 75, suffered from an irrational fear and a “deep sense of dread,” not to mention “a high level of anxiety” that was “bolstered by a whole range of cognitive distortions.”

    Prosecutors responded in their filing that “the government believes that, in the absence of any addiction or serious mental condition, greed fueled this opportunistic crime.”

    Prosecutors asserted that Pine submitted claims for non-existent treatments “on a near daily basis, week in and week out, year end and year out.” Over the period of time examined by investigators, Pine was defrauding Medicaid on an average of $4,635 per week, they said.

    The analysis of Medicaid billing records shows that Pine routinely billed Medicaid for 12 or more hours of services each weekday, except for major holidays, for years. At the same time, records show that he was treating paying clients with private insurance.

    In a 1994 interview with the New York Times, Pines described his specialty, detachment disorder, as an inability to show affection or concern for others as a result of the failure to bond with one’s parents because of parental abuse, abandonment or illness early in life.

    At the time, the newspaper said he was president of the Dallas-based Association for the Treatment and Training in the Attachment of Children.

    Pines has been a licensed psychologist in Connecticut for over 45 years. During the period in which the fraud took place, prosecutors said he was the sole owner and operator of Michael B. Pines, Ph.D., P.C. in Glastonbury, his psychology practice. He had been enrolled in the state Medicaid program since 2014.

    He worked primarily with children and adolescents with a variety of problems, including anxiety, depression, mood disorders, ADHD, autism spectrum disorders, behavioral disorders and notably issues related to trauma, loss and attachment.”

    As part of his sentence, U.S. District Judge Sarala Nagala ordered Pine to repay the stolen money. He has already returned more than $500,000 and turned over numerous pieces of jewelry to the government.

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