That’s the Way the Ball Bounces

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In the state of Oklahoma, Medicaid pays for behavioral health rehabilitation services that are designed to support and treat children and their families who are experiencing difficulties in their daily lives. The intent is to help them improve their lives through counseling by keeping the children in their natural environments. A behavioral health rehabilitation specialist in Oklahoma City befriended a family and used his position to bill Medicaid for more than $40,000 in services he did not provide.

The counselor, who contracted with the Oklahoma Health Care Authority to provide services to Medicaid recipients, became friends with a parent of four children with Medicaid benefits. He claimed that he spent several hours each day with all four kids. (In reality, he only spent time with the two male children playing basketball.)

The counselor used all four kids’ Medicaid identities to bill Medicaid for counseling services he did not perform. (A parent told investigators that he had never counselled the two female children.) In all, the Oklahoma Medicaid program was billed $42,267.66 using the children’s’ identities.

The 34-year-old counselor pleaded guilty to two counts of Medicaid fraud and one count of identity theft. The defendant was put on probation and not allowed to perform counseling services for any Medicaid beneficiary during his probationary period. He was also ordered to surrender any professional licenses.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Oklahoma City counselor pleads guilty to Medicaid fraud, identity theft,” posted on KFOR.com on October 13, 2016.

OKLAHOMA CITY – An Oklahoma City counselor pleaded guilty to Medicaid fraud and one count of identity theft.

Damon N. Wells, 34, was employed as a Behavioral Health Rehabilitation Specialist at Pennington Creek Life House.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.