The manager of an Oklahoma City optometry clinic which closed in October has now been charged with sixteen counts of Medicaid fraud. After an investigation by the agency's Medicaid Fraud Unit, the Oklahoma Attorney General's Office filed charges against Robert C. Camp, Jr., 52, of Mustang. Camp is accused of billing the Oklahoma Health Care Authority (OHCA), which oversees state purchased insurance SoonerCare (Oklahoma Medicaid), for eyeglasses that were never made or delivered to patients. The charges accuse Camp of making $359,459 in fraudulent claims since June 2011, billing the OHCA for 3,496 pairs of glasses when only 524 were manufactured and delivered to patients. Prosecutors allege that Camp billed for an additional 57 pairs of glasses after the clinic closed last month. Because Medicaid involves both state and federal agencies, fraud may be prosecuted either as a state offense or a federal offense. Penalties for conviction may vary depending on whether a crime was tried in federal court or Oklahoma district court. According to §56-1006 of the Oklahoma statutes:
Any person committing Medicaid fraud where the aggregate amount of payments illegally claimed or received is Two Thousand Five Hundred Dollars ($2,500.00) or more shall be guilty of a felony, and upon conviction thereof shall pay a fine of not more than three times the amount of payments illegally claimed or received or Ten Thousand Dollars ($10,000.00) whichever is greater, or be imprisoned for not more than three (3) years, or both such fine and imprisonment.
If the amount of fraudulently received funds is less than $2,500, the crime is a misdemeanor punishable by a fine of $1,000 or three times the amount of fraudulent payments, whichever is greater. Additionally, any person convicted of misdemeanor Medicaid fraud may be subject to a maximum of one year in jail.
Medicaid fraud may be committed by patients through duplicate applications or failure to report assets, income, or employment, but it is commonly perpetrated by healthcare providers. Types of provider-committed Medicaid fraud include:
- Accepting kickbacks
- Billing for a more expensive product than a patient receives (for example, billing for brand-name medications but giving a patient generic)
- Phantom billing, or billing for products or services not rendered
- Billing for unneeded services
- Double billing
Exact figures are not known regarding the prevalence of health care fraud in the United States. Some analysts project that three to ten percent of the more than a trillion dollars spent on health care is spent fraudulently. If you are accused of Medicaid fraud, it is important to quickly find a white collar crime lawyer who is experienced in both state and federal criminal defense. To learn more about white collar crime or to find a fraud lawyer in Oklahoma, please visit our criminal defense website at www.oklahoma-criminal-defense.com.