Psychiatrist Yvette K. Baker facing 62 counts of felony health care fraud; license already suspended on prescribing violations and excluded from Medicaid
December 9, 2011
A Delaware psychiatrist already under suspension for improperly prescribing narcotics and other violations has been arrested in Alabama for allegedly defrauding Delaware's Medicaid program of more than $172,000 over a three-year period.
Most of the charges against Yvette K. Baker involve prescribing painkillers with little or no documentation and receiving reimbursements from Medicaid for treatment from July 2006 through July 2009.
The fraud involved payments to Baker and the pharmacies that dispensed the medications, said Christina Showalter, director of the Medicaid Fraud Unit of the Attorney General's Office.
State officials are preparing extradition papers for Gov. Markell to sign so they can return Baker from Huntsville, Ala., where she was taken into custody in late October.
Baker, 52, had refused to waive extradition, officials said.
Though court papers do not identify the medications she is accused of improperly prescribing, Showalter said Wednesday that the drugs were prescription painkillers.
Authorities had been searching for Baker since July, when prosecutors filed 62 counts of felony health care fraud and two counts of making false statements against a doctor.
In July 2010, Baker's license to practice medicine in Delaware was suspended indefinitely. Though Baker is a psychiatrist, her suspension order said she "provided long-term pain management for many of her psychiatric patients.''
The criminal charges could result in a prison sentence for Baker if she is convicted. She is the second doctor charged criminally this year in connection with improper prescribing of prescription narcotics.
The other physician was Dr. Thomas F. Celello, who received probation after pleading guilty to one count of conspiracy for fraudulently writing prescriptions at a Stanton "pill mill'' where he prescribed nearly 140,000 doses of painkillers during 25 days of work in 2010, sometimes without conducting proper exams.
Law enforcement and public health officials in Delaware and nationwide call abuse of narcotics and anti-anxiety medications an epidemic. Those legal drugs diverted to illegal uses kill far more Delawareans than traffic accidents, or heroin and cocaine combined.
The probable-cause affidavit detailing her charges portrays her as a doctor who blatantly ignored her exclusion from the Medicaid program in 1996. She was barred then for owing more than $67,000 in federal education loans. She entered into an agreement that year to pay $1,000 a month on the loan, and the exclusion was "stayed,'' the affidavit said, but she made only one payment and the exclusion was reinstated in 1998.
Though the loan was declared uncollectable in 2009 and Baker was advised by letter that she could reapply for reinstatement, she never did, the affidavit said.
Baker, who previously practiced in Arkansas and Indiana, has been licensed in Delaware since 2002. She worked for the Franklin H. Everett and Associates clinic in Dover until 2006, when she opened the Psychiatric Wellness Center on South Governors Avenue, the affidavit said.
Despite her Medicaid exclusion, she applied for provider status with Delaware's program when she opened the wellness center. "There is no evidence that Dr. Baker notified [the Medicaid program] that she was excluded from health benefit programs,'' the affidavit said.
When a detective interviewed Baker in 2010, she said she had disclosed a problem about her loan to the licensing board and was permitted Delaware Medicaid officials did not respond to questions Wednesday about how and why Baker was granted provider status despite her exclusion by the federal government, which shares Medicaid costs with states.
Investigators searched Baker's home and office in April 2010, and found that she didn't have any patient files for 40 of her Medicaid patients, the affidavit said.
Under state rules, doctors must "maintain documentation sufficient to substantiate the medical necessity of the service provided, and must include a diagnosis that is consistent with the service billed,'' the affidavit said.
Agents went to several Dover-area pharmacies and found prescriptions written by Baker on dates that her records do not show that she treated the patient. Officials also learned that Delaware Medicaid officials had done audits of Baker from 2006 through 2008 and found repeated instances of insufficient documentation, failure to follow proper billing procedures and no evidence of a medical evaluation.
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