Therapist Agrees to Repay Bilked Money

A San Diego therapist pleaded guilty to bilking the U.S. government of almost $11,000 and agreed to repay the money, which he obtained by billing for treatments of military clients he had never seen, the U.S. attorney’s office said Tuesday.

Donald J. Shay, a licensed marriage counselor and family therapist, billed CHAMPUS during a five-year period beginning in 1985 for the treatment of military personnel and their family members who were never clients or who had ceased being clients, according to Assistant U.S. Atty. Kimberly D. Allan.

“It was a systematic thing; the false claims were filed over several years,” Allan said.

Sometimes, Shay would provide free vitamins to military families for their children in exchange for their billing information, she said. Other times, he would simply use a client’s billing information, even though he had stopped seeing that client.

Shay was unavailable for comment, and his attorney, David Cohen, did not return phone calls.

In a plea agreement, Shay pleaded guilty before U.S. District Judge Marilyn Huff to one count of filing false claims with the U.S. government. He also agreed to repay the $10,579.60 he garnered by filing false claims to the military insurance carrier CHAMPUS, the Civilian Health and Medical Program of the Uniformed Services.

Shay was first charged with 24 counts of false claims and tampering with witnesses. In making the plea agreement, however, he admitted his guilt to one count, saying he had filed for $1,380 reimbursement for counseling a person who was not a client, an offense which could be punished by up to five years in jail and $250,000 in fines.

Under the CHAMPUS plan, every participant is given an identification number that a doctor submits on his bills for reimbursement. Shay allegedly perpetrated his scam by using such numbers even when he had stopped seeing the clients. To prevent an individual from learning about the false claim, Shay used a phony address for the former client, Allan said.

In part, the scheme was facilitated by the fact that Shay’s clients stayed in military housing and moved frequently, making it difficult for investigators to unravel the scam.

Shay was charged after an investigation by the Defense Criminal Investigative Service of the Defense Department. He is scheduled to be sentenced in late July.