Fraud and abuse by providers a/Medicaid services remain a largely unexplored area of scientific inquiry. This study presents information an psychologists who have been either criminally or administratively sanctioned for violations of laws governing the Medicaid program. Mental health practitioners are disproportionately sanctioned compared to their numbers in the program, a situation at least partly due to the fact that they bill according to time spent with patients, making them easier enforcement targets. Interviews with 8 sanctioned psychologists and 40 state and federal officials involved in administrative and enforcement activities revealed that sanctioned psychologists were commonly charged with filing false claims, felt they were treated unfairly by the system, and resented the low reimbursement rates and paperwork involved with Medicaid. Almost all violators strongly denied personal blame for their behavior. These and related findings are discussed within the context of increased official scrutiny ofprofessimals who participate in government medical benefit programs.Medicaid, established in 1966, has extended medical benefits to indigent persons who, in many cases, otherwise would not have been able to obtain such care (Buchberger, 1981). A troublesome outgrowth of the program is that it has created new opportunities for malefactors to move outside the bounds of the laws and the rules regulating their professional behavior. Charging five patients each for an hour's individual therapy when, in fact, they had been seen for only 10 minutes is an unlikely violative tactic unless a third-party insurer is going to pick up the bill. Nor would it have been likely, without benefit programs, that a male therapist would bill the state for time spend in sexual dalliance with a patient: Medicaid, however, has been charged for such "treatment" on a number of occasions.In the foregoing sense, the establishment of the government medical programs also established a new type of lawbreaker. The programs enacted laws and created rules sidestepped by some practitioners for the purpose of self-aggrandizement (Pontell, Jesilow, & Geis, 1982). The impersonality of the administering bureaucracy can insulate wrongdoers against feelings of guilt (Smigel, 1956), and-as we shall see-the complex rules and low payments can provide therapists with rationalizations to deflect moral obloquy that might accompany acts of fraud and abuse. Medicaid offers a context in which persons who are inclined to enrich themselves by ignoring lawful regulations, can readily do so.By some counts, mental health practitioners appear to be the worst offenders against government medical benefit programs. From 1967 through 1982, 147 physicians were placed by the federal Health Care Finance Administration (HCFA) on a list of persons extruded from further participation in Medicaid and/or Medicare because of acts of fraud or abuse. Of these, 27 (18.4%) were psychiatrists. Yet psychiatrists make up only about 8% of the physician population (Harris & Associates, 1...