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Records Show State Medical Board Failed to Act on Complaints Against Chairman Brian Hyatt

8 min read

Years before Dr. Brian Hyatt of Rogers resigned as chair of the Arkansas State Medical Board after “credible allegations” of Medicaid fraud, the board received two complaints about Hyatt’s billing practices but took no action.

In the two complaint cases, board members found no evidence that the northwest Arkansas psychiatrist had violated the Arkansas Medical Practices Act, according to letters the board issued in February 2019 and December 2020. The letters, released under the Arkansas Freedom of Information Act, were written while Hyatt was serving on the board.

Brian Hyatt

Now Hyatt, who owns Pinnacle Premier Psychiatry of Rogers, is under investigation by authorities for fraud and facing multiple lawsuits by former patients.

Hyatt, who served on the Medical Board from 2019 until his resignation on May 16, has not been charged with a crime. “I am not resigning because of any wrongdoing on my part but so that the Board may continue its important work without delay or distraction,” Hyatt wrote in his resignation letter. “I will continue to defend myself in the proper forum against the false allegations being made against me.”

The U.S. Attorney’s Office for the Western District of Arkansas and the Drug Enforcement Administration are investigating Hyatt’s activities, according to a spokesman, who wouldn’t comment further because the inquiry is continuing. A Feb. 24 letter from the Office of Medicaid Inspector General also confirmed that Hyatt is suspected of fraud.

The DEA searched Hyatt’s office on May 23.

“Dr. Hyatt continues to maintain his innocence and denies the allegations made against him,” Hyatt’s legal team said in a statement to Arkansas Business. “Despite his career as an outstanding clinician, Dr. Hyatt has become the target of a vicious, orchestrated attack on his character and service. He looks forward to defending himself in court.”

Meanwhile, more than a dozen patients have filed civil lawsuits against Hyatt this year in Washington County Circuit Court, alleging outrage in connection with keeping patients against their will in the inpatient behavioral health unit. The complaints allege it was done “for the sole purpose of fraudulently billing for treatment that was not provided,” according to a lawsuit filed by one of the plaintiffs’ attorneys, Aaron Cash of the Herrera Law Group of Rogers. Cash said that he has more than 60 clients who say they were held against their will at Northwest Arkansas Hospitals LLC, which operates Northwest Medical Center-Springdale Inpatient Behavioral Health Unit. Hyatt was the medical director between 2018 and May 2022.

Hyatt’s legal team denied that he held patients against their will.

“Dr. Hyatt did not mistreat patients and, despite the false allegations being levied against him, will not contribute to others’ mistreatment of these patients by commenting on their mental health care in the press,” the statement said.

In April, Northwest Arkansas Hospitals agreed to repay Arkansas’ Medicaid program $1.1 million for nearly 250 claims related to Medicaid patients treated in Northwest’s behavioral health unit.

“The submissions were based on medical evaluations, diagnosis and other supporting documentation created by the unit’s former independent medical director Dr. Brian Hyatt and non-physician providers working under his supervision and direction in the unit,” a spokeswoman for Northwest Health told Arkansas Business via email. “While we believe hospital personnel complied with Arkansas law in all respects, Arkansas law heavily relies on the treating physician’s assessment of the patient, which was provided by Dr. Hyatt. And, while there is no evidence that the hospital intended to submit improper claims, we also believe settlement is in the best interest of the organization at this time.”

Hyatt denies any wrongdoing related to Medicaid billing, according to the statement from his lawyers.

“Medicaid billing is a complicated, and not always consistently administered, system that does not make it easy for providers,” the statement said. Hyatt “has followed the guidelines as he understands them and the guidance he has received over the years as it pertains to them.”

“Conclusions about his billing without close attention to — and an understanding of — the patient population, services, and other details are speculative and not based on the individual facts pertaining to each patient.”

Promising Start

Born in Anaheim, California, Hyatt graduated from the University of Arkansas at Little Rock in 1999 with a bachelor’s in psychology, according to his CV on file with the Medical Board.

After graduating from the University of Arkansas for Medical Sciences in 2004, Hyatt did his four-year residency at UAMS in psychiatry, where his career started with promise and success, according to his letters of recommendation on file at the Medical Board.

Hyatt “has demonstrated excellent interpersonal and communication skills,” wrote Dr. Ben Guise, director of residency training at UAMS, in a July 2005 letter. “Dr. Hyatt consistently demonstrates good moral character and high ethical standards and exhibits professional behavior.”

Hyatt received his medical license in 2005, and before he practiced in northwest Arkansas, he worked for more than 10 years as medical director for St. Vincent Infirmary in Little Rock.

Medicaid Findings

Questions over Hyatt’s billing first surfaced in November 2015, when the Office of the Medicaid Inspector General reviewed the medical records of 74 beneficiaries under Hyatt’s care and found 328 instances involving 67 beneficiaries “where the documentation was not sufficient to support services billed,” according to its report.

The OMIG said Hyatt should refund $17,578 and implement a corrective action plan.

In an April 30, 2015, letter to the Arkansas Medicaid Program, Hyatt said that he had “already instituted meaningful changes to my documentation based on the feedback I have been provided. I recognize that it is not just my duty to provide excellent care but also to ensure this is readily evident to your office when requested.”

In August 2017, the OMIG once again audited Hyatt’s Medicaid records, for February 2017, and found no documentation for certain services billed and that the services provided didn’t meet the correct billing codes for the procedures. It required Hyatt to repay Medicaid $9,847.

‘A Tremendous Resource’

In January 2018, Hyatt became the medical director of the behavioral unit located inside Northwest Medical Center-Springdale. He was the only psychiatrist employed or allowed to treat patients within the unit, according to a lawsuit filed by Cash, the plaintiffs’ attorney.

Hospital leaders were counting on Hyatt. In 2019, Northwest Health said it wanted to further develop its behavioral health unit, seeing “a tremendous need for growing behavioral health services” and planning to expand its inpatient unit to meet “significant demand,” according to Denten Park, Northwest Health’s market CEO, in the September/October 2019 issue of Healthcare Journal of Arkansas. “Our new medical director, Dr. Brian Hyatt, has been a tremendous resource.”

Dr. Brian Hyatt allegedly billed more Medicaid recipients at the highest code, 99233, than any other doctor billed for all of their Medicaid patients, according to a Jan. 17 affidavit filed by Mary Bowen, an investigator for the Medicaid Fraud Control Unit with the Arkansas Attorney General’s Office. Hyatt’s legal team has denied any wrongdoing related to Medicaid billing. (Source: Mary Bowen’s affidavit.)

But by then, Hyatt had received his first Medical Board complaint, in 2018, from a Northwest Health behavioral health unit patient who alleged that Hyatt had abruptly ended all his medication. In his response, Hyatt told the board that he provided proper care and that the patient’s chart showed that he received his medication. Hyatt also said how difficult his job could be.

“I knew good and well when I chose psychiatry as my career that my workdays would be short on gratitude,” Hyatt wrote on April 24, 2018. “I work on one of the toughest units in the country and I’ve been spit on, beaten, and I am cursed daily by the people I am trying my darndest to help. … After 14 years, I still greatly enjoy my job with the sole exception of incidents such as these.”

The Medical Board found that there was no evidence of a violation of the Arkansas Medical Practices Act and closed the case.

‘Would Advise an Audit’

In September 2018, Hyatt started seeing patients at his own clinic, Pinnacle Premier Psychiatry of Rogers, which is separate from the hospital’s behavioral unit.

Soon after the clinic opened, a father filed a complaint with the Medical Board on behalf of his daughter about the bill she received.

The father said in a Nov. 19, 2018, letter that his daughter had to pay $336 before she saw Hyatt. The father said his daughter told him that “her face-to-face visit with Dr. Hyatt lasted only 10 minutes.” He said that, before seeing Hyatt, she had spent five minutes with Hyatt’s nurse.

The father wrote that he had been in health care administration and was familiar with billing codes. “There was no way her 10 minutes with Dr. Hyatt could justify these codes and their accompanying charges,” the father wrote.

He said that after his daughter asked for her medical records, she was discharged as a patient and told that her charge was canceled.

“I wonder how many other patients were treated this way and would advise an audit of his records and subsequent charges,” the father wrote.

In a six-page response letter to the board on Dec. 4, 2018, Hyatt denied wrongdoing and said the patient was appropriately treated and billed. He wrote that psychiatric billing is different from a primary care physician’s office.

Hyatt said that the woman wasn’t discharged “due to any sort of financial dispute, she was discharged for the numerous badgering and abusive phone calls our staff had to endure,” Hyatt wrote.

“I hope this answers your questions and I’m embarrassed this has wasted everyone’s time,” he added.

On Feb. 13, 2019, the Medical Board found no evidence of a violation of the Arkansas Medical Practices Act and closed the case.

In September 2020, the Medical Board received another complaint that included a reference to Hyatt’s billing.

The patient said he was being treated at Northwest Medical Center-Springdale in November 2019, and that Hyatt “skipped patient’s room one day during morning rounds but still billed patient as having been seen that day.”

The one-page complaint didn’t say why it was being filed nine months after his visit.

But Hyatt responded that the patient’s claim was “as offensive as it is untrue.”

Hyatt said that he pushes a computer cart from room to room with a tech. “We walk down the hall bouncing from one room to the next every day and in the same order,” Hyatt wrote. “It would be darn near impossible for me to miss a room.”

He added that in his career, “I have missed one patient on one singular occasion (they were off the floor getting an [electroencephalogram] and I just plain forgot about them).” And when he learned about it, he returned to the hospital and saw the patient.

“I apologize that the Board has to waste its time on this Complaint but I suppose it is to be expected given my chosen specialty,” he wrote.

In December 2020, the Medical Board found no violations of the Arkansas Medical Practices Act and dismissed the case.

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