Philadelphia authorities arrested a Delaware County man last week for allegedly practicing medicine at a Northeast clinic even though he does not have a medical license.
The district attorney’s office charged Patrick Usanga, 63, of Folcroft, on April 10 with insurance fraud (27 counts), theft by deception (11 counts), attempted theft (27 counts) and tampering with public records (10 counts), stemming from an investigation into Northeast Behavioral Medicine at 6800 Castor Ave. The DA’s office, the Social Security Administration and the U.S. Department of Labor began the probe last year after an Independence Blue Cross investigator tipped them about the possible fraud.
Usanga opened and incorporated the business as “a medical clinic providing psychiatric and chemical treatment counseling,” the DA’s office said, although no one at the facility, including Usanga, was licensed to provide such treatment.
Nonetheless, Usanga allegedly sought reimbursements of more than $15,000 from Independence Blue Cross and $5,000 from Aetna for mental health procedures performed at the clinic. Patients of the clinic allegedly told investigators that Usanga provided their medical treatments, although claim forms filed by Usanga to insurance companies identified other employees as the attending physicians. None of those “providers” held medical licenses.
In a separate alleged scam linked to the clinic, Usanga filed for unemployment in March 2009 and collected more than $55,000 in compensation, although records show that he saw patients, submitted forms to insurance companies and received insurance reimbursements during the period when he claimed to be unemployed. He reported to the state’s unemployment compensation system that he was seeking employment at Northeast Behavioral Medicine, although he operated the facility, according to the DA’s office.
The state’s Department of Public Welfare revoked the medical center’s license last year after learning that the center did not employ any licensed doctors or counselors.
Usanga is in Philadelphia prison custody in lieu of $200,000 bail. A preliminary hearing date has not been set. ••
Reporter William Kenny can be reached at 215–354–3031 or [email protected]
