Brendan Luke Vaughn: The Benevolent Society former therapist in misconduct probe for overbilling patients

An occupational therapist who overbilled vulnerable NDIS patients thousands of dollars in inflated invoices claims he only carried out the conduct in order to meet strict KPI billing targets.

An occupational therapist who overbilled vulnerable NDIS patients thousands of dollars in inflated invoices claims he only carried out the conduct in order to meet strict KPI billing targets.

Brendan Luke Vaughn has been found guilty of professional misconduct by the NSW Civil and Administrative Tribunal after he inappropriately billed clients a total of $16,686.46 while working at not-for-profit organisation The Benevolent Society in 2020.

Mr Vaughn was found to have fraudulently billed 21 patients on 83 occasions for services he did not provide to them.

The tribunal heard Mr Vaughn’s conduct was carried out over a nine-month period and only came to an end after the mother of one client was left “shocked” at a billing statement and suspected she had been charged for services not performed.

The client’s mother went on to contact The Benevolent Society which terminated Mr Vaughn’s employment after becoming aware of his conduct in September 2020.

Mr Vaughn had worked at the Benevolent Society since 2017.

The tribunal heard Mr Vaughn was suffering anxiety at the time of the conduct and was not motivated by personal financial gain, but rather to keep up with his required KPI targets around billing in order to maintain his employment.

Mr Vaughn, who began working at the non-profit care provider in 2017, had been aware of the importance and requirement of appropriate billing by The Benevolent Society and had a performance objective to achieve a billable client service hours target of five hours each day as outlined in a “performance improvement plan”.

Patients were overbilled by more than $16,000.

In a meeting with The Benevolent Society, he was warned that failing to book in the required number of client billable appointments on a consistent basis and meeting those targets may have resulted in disciplinary action including termination of his employment.

A report by psychiatrist who assessed Mr Vaughn’s stated he had been experiencing anxiety at the time of the conduct and engaged in his behaviour to “try and salvage his position” in the workplace which he believed was under threat.

The report added that Mr Vaughn’s behaviour involved multiple clients which enabled him both to try and conceal the misconduct but also to minimise the impact on the individual NDIS plans of specific clients.

The Health Care Complaints Commission – which took the case to the tribunal – said the clients were receiving NDIS funding based on their specific needs and it was “paramount this funding is appropriately accessed for services actually performed, including occupational therapy services, to ensure people living with disability receive the supports they require’’.

The decision was handed down by the NSW Civil and Administrative Tribunal on Thursday.

The tribunal, in its decision on Thursday, said Mr Vaughn’s conduct lacked “integrity, honesty and transparency”.

“Mr Vaughn had worked for The Benevolent Society since 2017 and so ought to have been aware of the appropriate billing methods for clients,” it said.

“(His) conduct demonstrates a failure to comply with the standards expected of an occupational therapist in that it lacks integrity, honesty and transparency.

“There is no evidence that the thought processes of the practitioner were impaired to the extent that he did not understand that his conduct was fraudulent. His conduct was deliberate and done with intent to assist him in his employment.

“As such the conduct was contrary to the NDIS code of conduct and contrary to the standards of the Occupational Therapy Board of Australia”

The tribunal found Mr Vaughn guilty of professional misconduct and unsatisfactory professional conduct of a sufficiently serious nature to justify suspension of his medical registration.

Mr Vaughn was disqualified from registering as an occupational therapist for a period of two years and ordered to pay costs to the Health Care Complaints Commission.

In a statement, The Benevolent Society said that due to legal reasons it could not comment on individual employees past and present.

“The Benevolent Society takes the welfare of its clients very seriously. We take appropriate action to deal with any breaches of our operational policies, including reporting it to the relevant regulator where required,” a spokesman said.

“We continuously review our systems and make improvements, so we are confident in their effectiveness.”