Sunday, August 29, 2010

California lawyer, wife arrested on charges of bilking San Francisco school district through fraudulent bills for treatment of autistic son

From the San Francisco Chronicle:

A former partner at a well-known law firm and his marketing consultant wife were arrested August 25 on felony charges of bilking the San Francisco school district and private insurers out of about $400,000 via fraudulent bills for treatment of their autistic son, officials say.

The San Francisco couple, Jonathan S. Dickstein and Barclay J. Lynn, both 43, surrendered Wednesday and are expected to appear in court this morning for arraignment on 30 counts of fraud, theft and conspiracy, authorities say.

They were briefly jailed Wednesday on $100,000 bail each but were released on bond.

"This was an elaborate scheme to defraud the school district and insurance companies out of a lot of money," said Chief Assistant District Attorney David Pfeifer. "They used this scheme to make money off their child's special needs - that's terrible."

Until this year, Dickstein, who graduated from Stanford and then Harvard Law School, was a partner at the internationally recognized San Francisco firm of Morrison & Foerster, specializing in intellectual property issues and the law surrounding life sciences. He has since started his own practice, according to his Facebook page.

He and his wife had arranged for the home care of their young son through another school district before transferring to the San Francisco school district. Under state guidelines, school districts are obligated to provide or compensate parents for home education of autistic or other severely disabled children.

By law, parents are required to use licensed private educational providers to develop individual treatment plans that meet state guidelines for their disabled children.

Dickstein and Lynn had employed such a private provider, but in 2006, they created their own: Puzzle Pieces. Prosecutors said it was actually a dummy company that was not licensed to develop autism education.

Double dipping
In fact, they say, the couple used Puzzle Pieces to overbill and "double dip" - charging both the school district and insurers for the exact same services - from 2006 to 2008. They billed for counselors and doctors at allegedly inflated rates and charged both the district and insurers for the same hours of treatment. They allegedly told insurers the district would not pay.

Gentle Blythe, spokeswoman for the district, said it was school officials who raised red flags to prosecutors last year.

"The parents weren't allowing the district personnel to talk to the service providers," Blythe said. She said it was then that the district uncovered the fact that Puzzle Pieces was not a licensed provider and in fact had been started by Lynn in 2006.

Dickstein's attorney, Garrick Lew, said the couple were devoted to their severely challenged son, but admittedly took efforts too far.

"They put a lot of work into getting whatever the child needed," he said. "In the process of getting all those needs met, there were problems."

He said he hopes to "try to work something out" with prosecutors.

Douglas Rappaport, Lynn's attorney, said that it was too soon to comment in detail but that there was "some indication that their conduct could be construed as lawful."

He said the couple volunteered many hours of their time to causes associated with autism.

The alleged fraud went undetected for about three years, until the school district assigned a new case supervisor over the education and treatment of the child last year.

Blythe said the district's earlier efforts to supervise the child's care met with resistance from the couple, but officials acted quickly when the problem was uncovered by the new supervisor.

The new supervisor noticed that Puzzle Pieces was charging twice what would typically be paid for in-home autism care and counseling for autistic children, prosecutors say.

A doctor who supposedly provided help had no specialty in autism, prosecutors say. Dr. Robert Schenck describes himself on the Internet as a specialist in depression in adults. He declined to comment.

When confronted about the questionable billings, the couple told authorities at the district that they did not have copies of the checks used to pay Puzzle Pieces.

Prosecutors said the couple attempted to pass off Puzzle Pieces as a company that they were not directly involved in, saying they would have to talk to the company people and get back to the district. But, Pfeifer noted: "They are the company."

Thousands in losses
According to prosecutors, the district lost as much as $240,000 while Anthem Blue Cross lost an estimated $100,000 and CIGNA, which administered the law firm's health plan, lost about $40,000.

In an Internet profile, Lynn said that from March 2006 until June of this year, she was a "director" of "private autism services" and that she "designed and directed (an) individualized home education program for (a) child affected by Autism" that combined "best practices" in " therapies and techniques ..."

She said that the "10 year old child in question went from an 'untestable' IQ in 2004 to being able to reach (sic) at a 2nd grade level, write several pages of text and is able to do 2nd grade math."

Lew, Dickstein's attorney, said the couple got overwhelmed as they worked with the many intricacies involved in securing care for their son.

"They were dealing with multiple agencies," he said. "Somehow things kind of went south. It's really unfortunate for them, as people, and also for their kid."