Rogers Psychiatrist’s Testimony Under Scrutiny Amid Medicaid Fraud Charges

Dr. Brian Hyatt (Arkansas State Medical Board)

Dr. Brian Hyatt of Rogers swore in 2020 that it was crucial for him to see his psychiatric patients face-to-face frequently when they’re hospitalized.

“So if I’m able to see them several times in one day, I’m able to keep an eye on things to make sure that somebody’s not getting violent or agitated or that the nurses aren’t missing something,” Hyatt testified in the hearing before the Arkansas Department of Health more than three years ago.

But that testimony stands in sharp contrast to current Medicaid fraud allegations against Hyatt, a former chair of the Arkansas State Medical Board.

Authorities have accused Hyatt of failing to enter patients’ rooms at Northwest Medical Center-Springdale Inpatient Behavioral Health Unit, where he was medical director between 2018 and May 2022.

A review of hundreds of hours of surveillance video from the hospital found that Hyatt never had direct contact with any patient there and never entered any patient’s room, according to a Jan. 17 affidavit sworn by Mary Bowen, an investigator for the Medicaid Fraud Control Unit with the Arkansas attorney general’s office.

Hyatt “takes a computer cart and walks from one end of the hall to the other,” Bowen wrote. “Sometimes he pauses at the rooms and may even look in, but he does not enter the room or have patients come out into the hall.”

The U.S. attorney’s office for the Western District of Arkansas and the Drug Enforcement Administration are investigating Hyatt’s behavior, according to a spokesman, but as of last week, no charges had been filed. The attorney general’s office also said it is investigating Hyatt, but it too had not filed charges against Hyatt as of last week.

“Dr. Hyatt continues to maintain his innocence and denies the allegations made against him,” Hyatt’s legal team said in a May 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.”

Buchanan Public Relations of Philadelphia, which is representing Hyatt, didn’t immediately respond to  messages from Arkansas Business.

The transcript of Hyatt’s testimony before the Health Department’s Office of Medicaid Provider Appeals was obtained by Arkansas Business under the Arkansas Freedom of Information Act.

It gives insight into the mindset of Hyatt, who also owns Pinnacle Premier Psychiatry of Rogers and is facing multiple lawsuits by former patients. Those suits claim outrage, alleging that Hyatt kept patients against their will in the inpatient behavioral health unit.

The complaints claim the patients were kept “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 last week that his firm and the Odom Law Firm of Fayetteville have 30 lawsuits, and there are more than 60 other clients who could be filing a lawsuit against Hyatt.

Hyatt’s legal team said he never 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.

Safety ‘Utmost Concern’

The hearing in which Hyatt appeared in 2020 was part of a group of appeals from Northwest Medical Center for denials of Medicaid claims from the Arkansas Department of Human Services, Division of Medical Services.

Medicaid rules require hospitals to have approval for inpatient hospitalizations that will last longer than four days. Medicaid patients will have their hospitalizations covered after the fourth day if their stay is considered medically necessary. The Arkansas Foundation for Medical Care has a contract with DHS to assess the claims.

The hearing transcript didn’t provide specific details about the cases being appealed.

During the hearing, Hyatt criticized AFMC’s findings because the psychiatrists who reviewed the cases never quizzed the patients.

He said that AFMC couldn’t make an assessment “without ever interviewing that patient, knowing nothing about them or seeing what’s going on in the unit. You absolutely cannot make a determination of whether they could be safely discharged,” Hyatt said. “That’s just … absurd.”

He said that he has to feel comfortable about his decision to discharge a patient.

“We’re not talking about folks that have influenza or a cold,” he said. “We’re talking about folks that can wreak havoc in the mall or show up on your front lawn.

“Safety is of the utmost concern,” he said.

Hyatt said that his patients can leave the hospital when he determines that they can move to the next treatment level that doesn’t involve being in a locked unit with 15-minute checks.

He said that the frequent hospital rounds he makes provide him with a lot of information about the patient.

“Nobody has ever left one of these facilities waving saying, see you later, folks, I’m headed home to kill myself,” Hyatt said. “But it happens.”

The identities of the psychiatrists who did the reviews for AFMC are kept confidential, but Hyatt questioned their experience. He said that he suspects the psychiatrists who reviewed his cases probably have had patients who committed suicide.

“That number for me is zero,” Hyatt said. “So I would say that, in a field where all I have is my judgment … it’s been pretty good so far.”

But one of his patients allegedly committed suicide in January 2020 — less than two months before the hearing, according to allegations in a lawsuit that was filed in 2021. It’s unclear if Hyatt knew about the death at the time of the hearing. He denied allegations of wrongdoing in pleadings in the case, which is pending in Washington County Circuit Court.

Hyatt also said he documents the patients’ condition in their charts and attests that the admission to the psychiatric facility is medically necessary.

Hyatt said that he takes it seriously when he says he approves the documents.

“Well, even though I’m not from the South, I feel that my word is everything,” said Hyatt, who grew up in California.

But Bowen, the investigator with the Medicaid Fraud Control Unit, raised concerns about Hyatt’s patients’ files.

She said that Hyatt developed templates for the progress notes that went on for pages and cited laws and regulations “and even warnings to regulators not to challenge his finding.”

Those notes created volumes of records for each patient but were “completely void” of information about how the patient was doing on a particular day, Bowen wrote.

“Dr. Hyatt may try to claim that all he had to do was see the patient, but he knows that this is not enough to evaluate a patient’s current condition and diagnosis,” she wrote in her affidavit.

Financial Motivation Denied

Hyatt said he didn’t take the job at Northwest Medical Center because of the money.

His outpatient clinic Pinnacle Premier Psychiatry was “very successful,” Hyatt said in the 2020 hearing.

Hyatt said that if he was motivated by money he wouldn’t treat inpatient psychiatric patients, who “have broken my ribs on multiple occasions, spit in my face, cursed me daily,” Hyatt said.

But he said he enjoys that patient segment. “Nobody else is interested in treating this population, and I take great pride in doing an excellent job in doing it,” Hyatt said.