According to Charles Ornstein of ProPublica, a few years ago Illinois' Medicaid program noticed some odd trends in its billings for group psychotherapy sessions. For example, nursing home residents were being taken several times a week to off-site locations, and Medicaid was picking up the tab for both the services and the transportation.
In addition, the sessions were often being performed by obstetricians and gynecologists, oncologists and urologists — "people who didn't have any training really in psychiatry," Medicaid director Theresa Eagleson recalled.
So Medicaid began cracking down, and spending plummeted. Yet Illinois doctors are still billing the federal Medicare program for large numbers of the same services.
Medicare paid Illinois providers for more than 290,000 group psychotherapy sessions in 2012 — more than twice as many sessions as were reimbursed to providers in New York, the state with the second-highest total.
Among the highest billers for group psychotherapy in Illinois were three OB-GYNs and a thoracic surgeon. The four combined for 37,864 sessions that year, more than the total for all providers in the state of California. They were reimbursed more than $730,000 by Medicare in 2012 just for psychotherapy sessions, according to an analysis of a separate Medicare data set released in April.
Of the Illinois OB-GYNs billing for group psychotherapy, Dr. Josephine Kamper had the highest number of sessions. She was paid for 10,399 sessions in 2012, at a cost to Medicare of $207,980.
In 2011, the state Department of Financial and Professional Regulation placed Kamper on two years' probation for failing to evaluate a patient undergoing an abortion prior to anesthesia and failing to collaborate with a certified registered nurse anesthetist. The terms of her probation did not prohibit providing psychotherapy.