State Medical Board Chair Steps Down Amid Fraud Accusations

As chair of the Arkansas State Medical Board, Brian T. Hyatt, MD, often sat in judgment of other physicians. Now, state officials are investigating the psychiatrist for alleged Medicaid fraud. He has stepped down as board chair, and state officials have suspended all Medicaid payments to Hyatt and his practice, Pinnacle Premier Psychiatry in Rogers, Arkansas.

Hyatt billed 99.95% of the claims for his patients’ hospital care to Medicaid at the highest severity level, according to an affidavit filed by an investigator with the Medicaid Fraud Control Unit, Arkansas Attorney General’s Office. Other Arkansas psychiatrists billed that same level in only about 39% of claims, the affidavit states.

The possible upcoding alleged in the affidavit was a red flag that prompted the state to temporarily suspend Hyatt’s Medicaid payments.

Hyatt has until this Friday to file an appeal. He did not respond to requests from Medscape Medical News for comment.

The affidavit pointed to other concerns. For example, a whistleblower who worked at the Northwest Medical Center where Hyatt admitted patients claimed that Hyatt was only on the floor a few minutes a day and that he had no contact with patients. A review of hundreds of hours of video by state investigators revealed that Hyatt did not enter patients’ rooms, nor did he have any contact with patients, according to the affidavit. Hyatt served as the hospital’s behavioral unit director from 2018 until his contract was abruptly terminated in May 2022, according to the affidavit.

However, Hyatt claimed to have conducted daily face-to-face evaluation and management with patients, according to the affidavit. In addition, the whistleblower claimed that Hyatt did not want patients to know his name and instructed staff to cover up his name on patient armbands.

Detaining Patients 

Hyatt also faces accusations that he held patients against their will, according to civil lawsuits filed in Washington County, Arkansas, reports the Arkansas Advocate. 

Karla Adrian-Caceres filed suit on January 17. Adrian-Caceres also named Brooke Green, Northwest Arkansas Hospitals, and 25 unidentified hospital employees as defendants.

According to the complaint, Adrian-Caceres, an engineering student at the University of Arkansas, arrived at the Northwest Medical Emergency Department after accidentally taking too many Tylenol on January 18, 2022. She was then taken by ambulance to a Northwest psychiatric facility in Springdale, court records show.

According to the complaint, Adrian-Caceras said that she was given a sedative and asked to sign consent for admission while on the way to Northwest. She said that she “signed some documents without being able to read or understand them at the time.”

When she asked when she could go home, Adrian-Caceres said, “more than one employee told her there was a minimum stay and that if she asked to leave, they would take her to court where a judge would give her a longer stay because the judge always sides with Dr. Hyatt and Northwest,” according to court documents. Northwest employees stripped Adrian-Caceras, searched her body, took all of her possessions from her and issued underwear and a uniform, according to the lawsuit.

Adrian-Caceres’ mother, Katty Caceres, claimed in the lawsuit that she was prohibited from seeing her daughter. Caceres spoke with five different employees, four of whom had only their first names on their badges. Each of them reportedly said that they could not help, or that the plaintiff “would be in there for some time” and that it was Hyatt’s decision regarding how long that would be, according to court documents.

Katty Caceres hired a local attorney named Aaron Cash to represent her daughter. On January 20, 2022, Cash faxed a letter to the hospital demanding her release. When Caceres arrived to pick up her daughter, she claimed that staff members indicated that the daughter was there voluntarily and refused to release her “at the direction of Dr Hyatt.” During a phone call later that day, the plaintiff told her mother that her status was being changed to an involuntary hold, court documents show.

“At one point she was threatened with the longer time in there if she kept asking to leave,” Cash told Medscape Medical News. In addition, staff members reportedly told Adrian-Caceres that the “judge always sided with Dr Hyatt” and she “would get way longer there, 30 to 45 days if [she] went before the judge,” according to Cash.

Cash said nine other patients have contacted his firm with similar allegations against Hyatt.

“We’ve talked to many people that have experienced the same threats,” Cash said. “When they’re asking to leave, they get these threats, they get coerced…and they’re never taken to court. They’re never given opportunity to talk to a judge or to have a public defender appointed.”

John McCormack is a Riverside, Illinois-based freelance writer covering healthcare information technology, policy, and clinical care issues.

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