Pittsburgh-area counselor stole $600K through alleged insurance fraud scheme

HARRISBURG — Pennsylvania Attorney General Kathleen G. Kane’s office announced the arrest of a Pittsburgh-area woman charged with illicitly obtaining more than $600,000 through an alleged insurance fraud scheme. The arrest was announced Wednesday.

The charges against Lisa A. Wally, 33, are the result of an investigation by the Office of Attorney General’s Insurance Fraud Section.

According to a criminal complaint, the investigation of Wally, a licensed professional counselor, began after investigators received a referral from Highmark Blue Cross/Blue Shield. The referral stated that Wally had billed for services that she never rendered and inflated billings that stemmed from services she did perform. The billings were for psychotherapy treatments, according to the criminal complaint.

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 alleged fraud took place from January 2011 through early 2015.

Investigators interviewed multiple patients who reviewed records related to Wally’s alleged overbilling scheme. Several of her patients told investigators the dates on the billings were incorrect. Many stated they covered time periods in which they were not seeing Wally, the criminal complaint states.

One former patient told investigators she only visited Wally once at her office in Uniontown, Fayette County. However, Wally submitted billings indicating she saw the patient roughly 400 times, according to the criminal complaint.

Another former patient told investigators Wally used some of the money from the alleged fraud to purchase a brand new automobile, expensive handbags and trips.

Moreover, the investigation revealed Wally had no patient records or documentation related to their sessions. Billings were submitted through a computer system, investigators reported.

Wally, formerly of 428 Biddle Ave., Apt. 2, Pittsburgh, is charged with one count each of insurance fraud, theft by deception and unlawful use of a computer. Her bail was set at $50,000 unsecured at a preliminary arraignment today.

A preliminary hearing is tentatively scheduled for Dec. 30. The case will be prosecuted by Deputy Attorney General Kara Cotter of the Office of Attorney General’s Insurance Fraud Section.

The Insurance Fraud Section is the largest law enforcement entity in Pennsylvania with specific authority to investigate and prosecute alleged insurance fraud.

(A person charged with a crime is presumed innocent until proven guilty.)

SOURCE: U.S. Attorney’s Office,

Related: Ms. Wally’s web site appears to be this one.

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