Tennessee Psychologist Donald McCoy Indicted for $2.16 Million Health Care Fraud

May 31, 2019

A grand jury for the U.S. District Court in Nashville has indicted Donald McCoy on a slew of health care fraud charges after he was arrested in December.

McCoy, who received his psychology license in 1999, faces felony charges of health care fraud, mail fraud, aggravated identity theft, money laundering and engaging in monetary transactions in property derived from specified unlawful activity.

According to the indictment, which was filed May 22, McCoy, an authorized TennCare provider, submitted false claims to the insurance company and BlueCross BlueShield of Tennessee for payment for therapy sessions never performed for four years. He targeted minors in the care of the Department of Children's Services in his scheme, allegedly swindling an estimated $2.16 million.

He'd often submit claims to insurances for more than 24 hours of service in a single day, which is impossible, according to the indictment. When TennCare and BCBST audited him, McCoy submitted false records and lied to the companies, the indictment says.

Original complaint

According to a Tennessee Bureau of Investigation analysis, in February 2018, McCoy submitted claims for sessions that totaled greater than 72 hours on that day. For 15 days between January 2014 and November 2018, McCoy submitted claims for sessions totaling more than 48 hours on each of those days. For 337 days, McCoy submitted claims for sessions that totaled more than 24 hours, the complaint says.

After the BCBST audit, TennCare performed an investigation. In May 2018, an investigator asked McCoy for medical records for the 50 patients McCoy had claimed to have seen on one day in February, which he couldn't produce.

McCoy submitted more than 40 claims for family sessions for a patient identified as Patient H. However, according to the patient's mother, the patient was in Department of Children's Services custody at the time and the family had never met with McCoy. She said she had only spoken with him on the phone once or twice.

On Dec. 13, agents from the TBI and United States Postal Inspection Service searched McCoy's home. During the search, the charging documents say that McCoy made "several spontaneous statements."

McCoy asked a TBI special agent if he needed to get a passport, if he was restricted from travel, what countries do not extradite to the U.S. and how hard the TBI would look for him if he fled the country.

If convicted, McCoy faces up to 20 years in prison and up to a $250,000 fine on each count. Additionally, he must forfeit any stolen money. His trial is scheduled for November 5 at 9 a.m., according to court records.

"During the pendency of this case, neither  Donald McCoy nor his attorney will have any comment," Mariah Wooten, McCoy's attorney, said in an emailed statement.

Source: “Murfreesboro psychologist indicted on new charges after arrest,” Daily News Journal, May 31, 2019. URL: https://www.dnj.com/story/news/crime/2019/05/30/murfreesboro-donald-mccoy-psychologist-indicted/1289499001/