Glastonbury Psychologist Gets Prison Time In $1.6M Medicaid Fraud Case

GLASTONBURY, CT — A Glastonbury-based psychologist is being sent to prison in a $1.6 million medicaid fraud case.

Vanessa Roberts Avery, United States attorney for the District of Connecticut, said that Michael B. Pines, 75, of Avon, was sentenced Friday by U.S. District Judge Sarala V. Nagala in Hartford to 27 months in prison, followed by three years of supervised release, for "defrauding Medicaid" of more than $1.6 million.

According to court documents and statements made in court, Pines is a psychologist who owned and operated Michael B. Pines, Ph.D., P.C., located in Glastonbury. Pines provided psychotherapy to young children, adolescents, and adults, and he was enrolled individually as a Behavioral Health Clinician provider in the Connecticut Medicaid Program, commonly known as Medicaid, Avery said.

Between January 2017 and October 2023, Pines submitted and "caused to be submitted" fraudulent claims to Medicaid for psychotherapy services that were purportedly provided to his Medicaid clients, Avery said. Specifically, Pines submitted claims for dates of service when no services of any kind had been provided to the Medicaid clients identified in the claims, including when he was traveling, on vacation, recovering from surgery, or otherwise not working, Avery said.

He also submitted claims when an appointment had been canceled, when the claimed client was in the hospital, when he had stopped treating the claimed client, and when the claimed client had never been his client. Avery said.

In addition, when Pines treated multiple Medicaid clients in the same family at the same time, he billed Medicaid for the group visit as multiple individual claims, a practice that he knew was not permitted by Medicaid," Avery said.

The investigation revealed that Pines used his business bank account for numerous personal expenditures, according to case records.

Through the scheme, Pines defrauded Medicaid of $1,617,679, according to case records.

Judge Nagala ordered Pines to make full restitution.

Pines also forfeited 16 pieces of jewelry, which he paid for using his business bank account, with an appraised replacement value of $67,685, according to case records.

On Jan. 31, Pines pleaded guilty to health care fraud.

Pines who is released on a $250,000 bond, is required to report to prison on June 24.