South Portland psychologist pleads guilty to health care fraud

Posted May 21, 2013, at 2:23 p.m.

SOUTH PORTLAND, Maine — A local psychologist is facing up to 10 years behind bars and a fine up to $250,000 after pleading guilty to health care fraud Tuesday.

Dr. Carole Orem-Hough, 55, of South Portland will be sentenced at a later date, according to U.S. Attorney Thomas E. Delahanty II. The sentencing date has not been announced.

Orem-Hough pleaded guilty in U.S. District Court in Portland before Judge George Z. Singal.

Court documents indicate Orem-Hough was a licensed psychologist at Casco Bay Psychotherapy in South Portland from 2008 to 2011.

Over the course of that time, she provided counseling services to patients and admitted she defrauded Aetna, Anthem Blue Cross and Blue Shield, Harvard Pilgrim and OptumHealth Behavioral Solutions by submitting claims for counseling sessions that never occurred.

Orem-Hough told one patient she double-billed Aetna because the company reimbursed her for half of what she earned from other companies, Delahanty said.

Delahanty said the case involved false claims with respect to nearly 50 patients and $69,000 in fraud loss.

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