An Arkansas psychiatrist held patients against their will and fraudulently billed Medicaid to the point it skewed the state's data, investigators say

• A prominent Arkansas psychiatrist is under state investigation for Medicaid fraud.
• Documents from state investigators say Dr. Brian Hyatt billed Medicaid to the greatest extent possible.

A "well-respected" Arkansas psychiatrist held patients against their will in an inpatient facility, refused to personally evaluate or check on them, and then claimed they were unstable so he could fraudulently bill Medicaid at the highest rate possible, according to documents filed earlier this year by Arkansas state investigators.

As Insider previously reported, seven former patients have sued Dr. Brian Hyatt and Northwest Medical Center, where Hyatt oversaw the behavioral-health services unit, alleging he trapped them in the facility. Three of those patients said they were not permitted to leave until sheriff's deputies arrived with court orders to escort them out.

A search warrant affidavit the Arkansas State Attorney General's Medicaid Fraud Control Unit filed in January documented allegations that Hyatt had fraudulently billed Medicaid, Medicare, and health insurance companies despite having "no contact with patients." The search warrant requested Hyatt's cellphone records between January 2019 and May 2022.

Hyatt, an attorney representing him in a separate legal matter, and his private practice didn't respond to Insider's requests for comment.

Hyatt's billing practices were so extreme that they skewed the data for the entire Medicaid program in Arkansas, the affidavit said. Doctors typically bill one of three "medical codes" each day of a patient's hospital stay: one indicating a patient is stable or improving, one indicating that a patient is responding inadequately, and one indicating a patient is unstable or has "a significant complication."

According to the affidavit, 99.95% of the continuing hospital care claims for Medicaid patients under Hyatt's care were billed under that third code, which bills at the highest rate.

In the affidavit's analysis of Arkansas' top 10 billers for subsequent hospital care, Hyatt "billed more Medicaid recipients at the highest code than any other doctor billed for all of their Medicaid patients." The affidavit noted that billing patients at an inappropriately high rate is a type of Medicaid fraud known as "up coding."

Northwest Health did not immediately respond to Insider's request for comment on the Medicaid fraud investigation, but previously told Insider that Hyatt had been an independent physician contracted to oversee the hospital's behavioral-health patients.

Hundreds of hours of footage showed no contact between Hyatt and patients, investigators said

The affidavit said Medicaid fraud investigators obtained two months' worth of footage from inside Northwest's behavioral health unit, and have reviewed hundreds of hours so far. The investigators said they saw no instances where Hyatt entered a patient's room or met with a patient outside their room.

The investigators wrote that on March 15, 2022, for instance, Hyatt could be seen making his rounds while never leaving the hallway to enter a patient's room. On that day in particular, Hyatt had 74 patients under his care and completed his rounds with an average of fewer than 20 seconds per patient, the affidavit said.

"These allegations raise numerous issues. The patients have a right to know their treating physician. If Dr. Hyatt was not their doctor, then who was?" the affidavit said. "At least some of the patients on the unit were being held against their will and only a physician could make the decision to impose a 72 hour hold."

Under Arkansas law, facilities like Northwest can hold patients involuntarily for up to 72 hours if they're deemed to be a danger to themselves or others, so long as they are evaluated by a physician within the first 24 hours. Facilities must obtain a court order to hold patients beyond 72 hours.

According to the seven lawsuits former patients filed, Hyatt had no legal authority to detain them in the facility against their will, even in cases when an involuntary 72-hour hold was implemented, since Hyatt or any other doctors never evaluated them.

Northwest Health "abruptly terminated" Hyatt's contract last May, according to the affidavit.

"We take very seriously our responsibility to provide a safe environment of care for our patients and for our team members," Northwest told Insider in a statement. "Last spring, we undertook a number of actions to ensure our patients' safety, including hiring new providers responsible for the clinical care of our behavioral health patients in early May 2022."