Counselor Accused of Billing While Gambling, Vacationing

A licensed professional counselor with Oklahoma Counseling Services is in serious legal trouble after allegedly falsely billing Medicaid for counseling sessions which never took place. According to court records, Annie G. King, 41, of Pryor, has been charged with three counts of Medicaid fraud in violation of Title 56 Sections 185, 243, and 1005.1 of the Oklahoma Statutes. Investigators say that King billed Medicaid for family counseling sessions with at least three mothers and their children who said that no such sessions took place. King is accused of fabricating progress notes for the families to lend credence to her claims that she was counseling them. However, according to the investigation, not only did these sessions never take place, the counselor was allegedly gambling at the Hard Rock Casino in Tulsa, taking sick leave, and on vacation during certain "sessions" for which she billed Medicaid. An affidavit in the case claims that King was gambling during business hours at least 26 times, and that her play card was in use at the casino during 18 of the sessions for which she billed Medicaid. She is alleged to have fraudulently received more than $14,000 from the Oklahoma Health Care Authority, which provides Medicaid reimbursements, between 2009 and 2011. Welfare fraud and Medicaid fraud take a number of different forms. Welfare fraud can include making false claims or omissions that allow a person to receive benefits to which he or she is not entitled. It can also include misuse of food stamps, including buying or selling food stamps or re-selling products obtained with food stamps. Medicaid fraud may involve a patient making false claims in order to fraudulently obtain health care benefits, but it frequently is perpetrated by the health care providers themselves. In these instances, the medical professional or mental health professional will bill the Oklahoma Health Care Authority for services not rendered, equipment not provided, or procedures not performed. Billing for services not rendered is perhaps the most frequent type of Medicaid fraud, but there are other types as well:

  • Double billing,  in which the provider bills both the Oklahoma Health Care Authority and a private insurer for equipment or services
  • Inflated billing by providing a patient with generic medications or less-expensive medical equipment, but billing Medicaid for the more expensive counterpart
  • Billing for unnecessary procedures or diagnostic tests which have no legitimate medical purpose
  • Upcoding, in which the provider inflates the extent of provided services
  • Unbundling, in which the provider breaks a medical procedure into its separate parts, billing for each rather than for the comprehensive procedure
  • Accepting kickbacks
  • Providing false cost reports for expense reimbursement
Medicaid fraud is considered a white collar crime. Penalties include not only years in prison and heavy fines, but also the destruction of one's professional reputation. Anyone accused of fraud should quickly obtain legal representation to minimize the impact of a fraud allegation.

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