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Counselor charged in insurance fraud overbilling scheme for more than $600,000

December 23, 2015 by  
Filed under Blog

A licensed professional counselor from McKeesport is accused of running a four-year insurance fraud overbilling scheme in which she illegally netted more than $600,000, the Pennsylvania attorney general’s office announced today.

Lisa A. Wally, 33, was arraigned today on charges of insurance fraud, theft by deception and unlawful use of a computer. Her attorney did not immediately return a message.

The attorney general’s office said its investigation began after Highmark Blue Cross/Blue Shield reported that Ms. Wally had billed for services she never provided and “inflated billings that stemmed from services she did perform.”

“Investigators said they learned Wally billed for 9,746 office visits related to 22 patients. In reality, only 1,987 of the visits actually occurred, meaning Wally was allegedly paid $601,280 for services she never performed,” the AG’s office said in a news release.

Former patients told investigators that dates on the billings were wrong and covered periods in which they weren’t seeking Ms. Wally’s services.

One reported visiting Ms. Wally only once at her Uniontown office, but she submitted billings showing she saw that patient about 400 times, the AG’s office said. Another claimed Ms. Wally used some of the money from the scheme to buy a new car, expensive handbags and trips.

A preliminary hearing is set for Dec. 30.

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