Burlington Woman Sentenced to Jail, Ordered to Pay Up to $570,000 for Billing Public Agencies for Unlicensed Mental Health Services
Defendant and Her Twin Sister Stole from Medicaid, Medicare and Lawrence Public Schools
WOBURN – A Burlington woman has been sentenced to jail and ordered to pay up to $570,000 in restitution for stealing from public agencies by billing for unlicensed psychological services, Attorney General Maura Healey announced today.
Nita Guzman, age 52, pleaded guilty on Friday in Middlesex Superior Court to the charges of Medicaid False Claims (2 counts), False Claims to Public Agency (1 Count), Larceny (4 Counts), and Unlicensed Practice of Psychology (2 Counts).
After the plea was entered, Judge Laurence Pierce sentenced Guzman to 18 months in the House of Correction, with five years of probation upon completing her sentence. He also ordered her to pay up to $570,000. A restitution hearing has been set for Feb. 7, 2017 in Middlesex Superior Court to determine the exact restitution amount.
“Guzman and her sister orchestrated a criminal scheme to provide and bill for unlicensed psychological and mental health services for patients, including children, that they were not qualified to offer,” said AG Healey. “Guzman stole more than half a million dollars from taxpayers and defrauded public agencies who provide important services to those in need.”
Guzman’s twin sister, Nina Tischer, pleaded guilty in February 2016 to charges of False Claims to Public Agency (3 Counts), Larceny (3 Counts), Identity Fraud (3 counts), and Unlicensed Practice of Psychology (3 Counts). She was sentenced to two-and-a-half years in the House of Correction, suspended for a probationary period of five years.
Guzman and Tischer were indicted in August 2014 by a Statewide Grand Jury. Both sisters lived in Minnesota at the time of the indictments. In September 2014, Guzman was arrested by a Minnesota County Sheriff and Tischer turned herself in, and they were subsequently arraigned in Middlesex Superior Court.
The AG’s investigation revealed that Guzman, through her company New England Psychological Consultants, Inc., billed Medicaid, Medicare, and Lawrence Public Schools more than $550,000 for unlicensed mental health services.
Her twin sister, Nina Tischer, through her company PsychSupport, Inc., billed a division of UMass Medical School more than $30,000 for unlicensed psychological examinations. Neither sister is a licensed psychologist, a legal requirement for practicing psychology in Massachusetts.
Through their corporations, both located in Lowell, the sisters provided bilingual psychological services to Medicaid and Medicare members in the greater-Lowell and greater-Lawrence areas, performed mental health disability evaluations for the Department of Transitional Assistance and the state’s Medicaid program (MassHealth), and assessed children for learning disabilities for Lawrence Public Schools.
The investigation of Guzman began when a licensed psychologist reported to the AG’s Office that Guzman’s company had used her name and license number without permission to bill a Medicaid managed care organization more than $430,000.
Additional investigation by the AG’s Office and federal agents from the Office of the Inspector General for Health and Human Services revealed that Guzman also used the name, license and other identifying information of a second psychologist to bill the managed care organization and the federal Medicare program more than $60,000 of services that the psychologist did not provide.
Guzman also billed the Lawrence Public School system more than $60,000 of psychological evaluations of students in special education programs. The evaluations were performed by Guzman or Tischer. State regulations require that any such evaluations be performed by a licensed psychologist.
The investigation of Tischer began when a licensed social worker reported the unauthorized use of her name and license by Tischer’s company, PsychSupport. Tischer used the social worker’s name and credentials to bill a division of UMass Medical School for disability examinations of people applying for Medicaid benefits or financial assistance from the Department of Transitional Assistance. Tischer billed UMass more than $8,000 for those evaluations.
Two additional professionals, a licensed mental health counselor and a licensed psychologist, also reported the unauthorized use of their names and licensing information by Tischer. The investigation revealed that Tischer billed UMass more than $30,000 for disability evaluations purportedly performed by the three professionals.
This case was handled by Assistant Attorney General Casey Groff of the AG’s Medicaid Fraud Division. It was investigated by Investigator Eric Panicucci, also of the AG’s Medicaid Fraud Division, the Department of Health and Human Services Office of the Inspector General, State Police assigned to the AG’s Office, and officials from the Division of Professional Licensure. The Wright County Minnesota Sheriff’s Office and Wright County Attorney’s Office also assisted in this case.