CARIBOU — A psychological examiner, charged with the second-largest Medicaid fraud in the state, was ordered Thursday to spend two years in prison, then pay back during a four-year probation period the $131,000 he stole from the government.

Michael Beitch, 44, a Limestone resident who had a private practice in Caribou, was charged with theft by deception by billing the federal program for client visits that never occurred. Last spring, Beitch entered a no-contest plea in the case.

“You’re going to enter the realm of the unfamiliar … the arena of public accountability,” Justice Paul T. Pierson said in issuing the sentence in Aroostook County Superior Court.

Beitch was sentenced to five years in prison, with all but two years suspended, and four years of probation. In addition to paying restitution, Beitch must abstain from alcohol and drugs, and undergo counseling. He also must complete 750 hours of community service.

Before issuing the sentence, Pierson read through a litany of about 40 credit-card statements and other debt amounts that contributed to Beitch’s desperate financial problems. It was apparent to the court that Beitch was attempting to hold his financial life together. Due to “highly unrealistic” expectations and living in a “fantasy” world, Pierson said, the crime was committed because Beitch’s financial obligations exceeded his income.

To suggest any different explanation “simply doesn’t make sense to me,” the justice said, after deliberating for about an hour.

Beitch originally was scheduled to be sentenced earlier this summer, but the judge hearing was postponed to allow for a more extensive background and psychological examination of the defendant.

The fraud was discovered during a review of bills coming in from Aroostook County, since the number was so high compared with the region’s population. Investigators also noticed that many of the patients suffered from the same diagnosis — “low self-esteem” — and many were members of the same family.

During Thursday’s hearing, Assistant Attorney General Kerry O’Brien argued that Beitch should receive a seven-year sentence and serve three years in jail, with four years of probation for the Class B crime, which is punishable with by to 10 years in prison.

Defense attorney Richard Currier of Presque Isle, however, argued for a three-year suspended sentence with two years of probation, restitution and 1,000 hours of community service.

In addressing the judge, Beitch disputed claims that he was not remorseful for his actions.

“Since this all began, I’ve grieved over it often,” said the defendant.

Later in his statement he said, “There has been serious remorse … my life has been put into quite a mess.”

Beitch has lost his professional license and is going through a divorce.

During the sentence hearing, the state attorney presented a psychologist, Dr. Martha Fantasia of Presque Isle, who conducted a personality test on Beitch. The test found that Beitch was basically a normal person who could have tendencies toward aggressive behavior.

Under cross-examination by Currier, Fantasia said that she was frustrated with the Medicaid system and its method of reimbursement. She testified, however, that she understood what constituted fraud.

In the past, Beitch has claimed that Medicaid regulations were confusing and that he was a poor record keeper.

The report of a substance abuse counselor also said that Beitch has the “potential” of developing an alcohol abuse problem, according to testimony in court.

Currier presented two witnesses who testified on Beitch’s extreme financial difficulties as well as his obligations to pay child support for his young daughter. An accountant, Galen Rockwell of Caribou, said that Beitch had a negative net value of $51,000. Rockwell also stated several times that Beitch owed tens of thousands in federal taxes.

E. Allen Hunter, a Caribou attorney representing Beitch in his divorce case, testified that Beitch will continue to be responsible for child support even if incarcerated.

Between 1991 and 1995, Beitch billed the Medicare system for 3,680 visits that didn’t occur.

As a psychological examiner, Beitch was licensed to conduct tests and do some counseling. He voluntarily surrendered his professional license to state regulatory officials, but will be able to reapply for it in two years, according to testimony heard Thursday.