Sooner Rather than Later


The Oklahoma Land Rush of 1889 occurred when approximately 50,000 individuals lined up to claim their piece of two million acres of unoccupied public land across the state. Those who entered the designated area before the official start of the land rush were called “Sooners” because they typically hid near their desired plot of land the night before the rush, then suddenly appeared to stake their claim hours before the legal settlers had a chance to do the same. (They staked their claim sooner than they should have if you know what I mean.)

You could say that today’s fraudster, a licensed professional counselor from Oklahoma City, Oklahoma, could be declared a “Medicaid Sooner.” He committed Medicaid fraud by submitting his false claims to SoonerCare, Oklahoma’s healthcare program jointly funded by federal and state government, before legitimate claims could be processed.

The Oklahoma City counselor owned his own counseling services firm, where he claimed to counsel individuals – primarily children. The story goes that the counselor billed for counseling sessions with multiple individuals at times and dates when he could not possibly be providing services. For instance, he billed for services when his clients were in school. He also submitted claims for times when he was actually talking to Oklahoma Health Care Authority representatives, not clients. Further research shows that he was at the YMCA while simultaneously providing a listening ear. (Somebody was definitely paying attention to the details in those fraudulent claims.)

The 61-year-old Oklahoma City man was charged with 224 counts of defrauding the Oklahoma Health Care Authority in a Medicaid fraud scheme that was carried out for the purposes of building up his bank account. Due to the overwhelming evidence of fraudulent claims, the counselor pleaded guilty to healthcare fraud and was sentenced to 366 days in federal prison, followed by three years of supervised release.

Fortunately, this “Medicaid Sooner” has already paid $141,545.16 in restitution to Medicaid. Part of those funds will go to SoonerCare and the remaining portion to Centers for Medicare and Medicaid Services. (He also must pay a $10,000 fine.) Congratulations to the Oklahoma Attorney General’s Medicaid Fraud Control Unit for stopping this behavioral health counselor sooner rather than later.

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, “Behavioral Health Counselor Sentenced to Prison for Defrauding Medicaid,” released on November 26, 2018.

OKLAHOMA CITY – SAMUEL OKERE, 61, of Oklahoma City, has been sentenced to a year in prison for Medicaid fraud, announced Robert J. Toaster of the United States Attorney’s Office and Mike Hunter, Oklahoma Attorney General.

Okere was a licensed professional counselor and owner of New Life Counseling Services.  On November 15, 2017, a federal grand jury charged him with 224 counts of defrauding the Oklahoma Health Care Authority through false claims for behavioral health counseling.  In particular, the indictment alleged that Okere billed for counseling sessions for multiple individuals, primarily children, at times when he could not have been counseling them.  For example, some of the times and dates billed were when clients were at school.  Others were when Okere was engaged in activities inconsistent with counseling, such as speaking on the phone with representatives of the Oklahoma Health Care Authority.

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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.