Telegram & Gazette (Massachusetts)

May 07, 2002 Tuesday, FINAL EDITION

Medicaid fraud is finally jailed

BYLINE: Lee Hammel; TELEGRAM & GAZETTE STAFF

SECTION: NEWS; Pg. A1

LENGTH: 856 words

Five years after a jury convicted him of larceny and filing false Medicaid claims, a former Worcester psychiatrist got handcuffs placed on him yesterday in Suffolk Superior Court.
Dr. Lorin H. Mimless, 50, his appeals exhausted, was led off to begin a one-year term in the Suffolk House of Correction. The state Appeals Court upheld his conviction on 219 counts of filing false Medicaid claims and two counts of grand larceny in 1993, 1994 and 1995, and the Supreme Judicial Court refused further review.
And so the contradiction that is Dr. Mimless- a hedonist who wore Armani suits and drove a $67,000 car, a psychiatrist who gave unstintingly of his time to desperately mentally ill patients, a man who ripped off the government and volunteered to work with AIDS patients in Kenya- was carted off to Roxbury, where Suffolk County’s South Bay House of Correction is located.
Dr. Mimless was convicted of defrauding Medicaid of $165,000. The jury found that he billed for more than 24 hours of patient counseling in a single day on 147 occasions, according to Nicholas J. Messuri, chief of the attorney general’s Medicaid Fraud Control Unit. In fact, he billed for more than 50 hours of counseling on one day, according to the state.
Dr. Mimless also was convicted of billing for counseling patients on 72 days when he actually was on vacation or at conferences in Alaska, Rome, the Caribbean and elsewhere.
The conviction came after a trial that seemed part soap opera. The jury heard from Dr. Mimless’s ex-wife, an heiress worth $600 million who refused to sign a joint tax return showing her husband made $513,000 in 1994 because ”I didn’t know any way a psychiatrist could make that much honestly.”
It also heard from the girlfriend who accompanied the married psychiatrist on numerous out-of-town trips, and on whom his ex-wife admitted siccing state Medicaid investigators. Prosecutors said Dr. Mimless’s motive was to finance a lifestyle in which he put $250,000 on a credit card for vacations and lavish gifts.
Dr. Mimless admitted that he overbilled Medicaid, but his lawyer, Michael D. Kendall, argued that it was a case of poor office management skills, not criminal intent. Mr. Messuri and Assistant Attorney General Mark Muldoon disputed that, saying Dr. Mimless ”put people in place where he could take advantage of their lack of experience and convince them to put bills in for work he did not do.”
The case gives prosecutors a new weapon in the state courts, according to Mr. Messuri. While federal case law allows prosecutors to use a concept of ”willful blindness” in U.S. courts, the state Appeals Court for the first time established that as an argument that can also be used in the state courts, he said.
It permits prosecutors to ask judges to instruct juries that they can convict a defendant who argues, as Dr. Mimless did, that someone other than he performed the fraudulent billing if the prosecution shows that he ”knew what was going on, but chose to look the other way,” Mr. Messuri said.
That is important in white-collar cases where the prosecution already has to overcome what Mr. Messuri called a jury’s natural inclination to be skeptical that someone legitimately making $250,000 a year, as Dr. Mimless was, would risk it all for another $50,000 a year illegitimately.
Besides a year in jail, Judge Vieri G. Volterra imposed five years’ probation and ordered Dr. Mimless to pay $165,843 restitution in his sentencing in July 1997. Inmates at the House of Correction are eligible to apply for parole after serving half of their sentence, Mr. Messuri said.
The state Board of Registration in Medicine revoked Dr. Mimless’ license to practice. He will be eligible to reapply for it June 17 this year, five years from when he stopped practicing.
The case was brought to the attorney general’s office by the state Division of Medical Assistance after Theodore Jones, anti-fraud coordinator for Mental Health Management of America, audited Dr. Mimless’ billing practices. Steven J. McCarthy and Anthony Megatlin picked up the investigation for the attorney general’s office.
Dr. Mimless lived in Providence while practicing at St. Vincent Hospital in Worcester. At the same time, he had an office at 390 Main St. in Worcester and, before that, on Madison Street.
After his sentence was stayed in 1997 pending his appeal, Dr. Mimless received permission from the judge to go to Africa to do volunteer work upon posting $30,000 bail. Noting he had to borrow the $30,000 for the bail, Dr. Mimless insisted outside the courtroom that by asking to work for what Judge Volterra said was his favorite charity, ”In no way are we attempting to do this to reduce the sentence.”
Judge Volterra is retired. Yesterday Dr. Mimless’s lawyer asked Suffolk Superior Judge Charles T. Spurlock to revise and revoke the sentence, taking into account Dr. Mimless’ good deeds in working with AIDS patients and survivors of the embassy bombings in Africa for four years.
The judge said he will consider the request, but ordered Dr. Mimless to jail.