The owner and employees of a now-closed counseling services provider under contract with Oklahoma to counsel Medicaid patients have been charged with Medicaid fraud. According to pleadings filed by the state’s attorney general in Oklahoma County District Court, the owner and four counseling service providers of Guthrie-based Pure Hope Corporation billed the state for services that were never provided.
According to the allegations, employees of the counseling services firm would bill the state for counseling session upon completing intake and assessment paperwork on new clients, before the clients ever received the services. Behavioral health care services are to be provided only after the patient is assessed and diagnosed, and a treatment plan is prepared. Pure Hope counselors, however, created fake session dates that predated patients’ intake dates and then generated fake progress notes using statements made by the patient during the actual intake process. These false progress notes were then submitted to the state as the basis for billing for services that were never provided.
Investigators interviewed counseling clients and the parents or guardians of under-age clients about their dates of services then compared the billing dates to the clients’ information. In the process, they discovered discrepancies between the dates of sessions billed and dates of intake and services reported by patients.
The executive director and owner of Pure Hope was arrested and charged with four counts of Medicaid fraud. Four employees, including the agency’s clinical director, a licensed counselor, a behavioral health rehabilitation specialist, and a clinical psychologist were also charged with one count each of Medicaid fraud.
Waters & Kraus is a national firm with highly skilled lawyers practicing qui tam litigation in four offices, including Dallas, Los Angeles, San Francisco, and Baltimore. Our attorneys have decades of experience successfully representing whistleblowers in a variety of fraud cases. Contact us or call our attorneys at 800.226.9880 to learn more about our practice and how we can assist.