Behavioral Counselor Sentenced for Fraudulent Medicaid Billing

Behavioral Counselor Sentenced for Fraudulent Medicaid Billing

The following press release was published by the U.S. Department of Justice, Office of the United States Attorneys on Sept. 26, 2018. It is reproduced in full below.

OKLAHOMA CITY - JOHN CLARENCE BRADLEY, 49, of Oklahoma City, has been sentenced to 24 days of weekend jail confinement and five years of probation for defrauding Medicaid, announced Robert J. Troester of the U.S. Attorney’s Office and Oklahoma Attorney General Mike Hunter.

A federal grand jury returned a 101-count indictment against Bradley on Dec. 13, 2017. As a licensed professional counselor under an agreement with the Oklahoma Health Care Authority ("OHCA"), Bradley had been submitting claims to SoonerCare, Oklahoma’s Medicaid Program, for behavioral counseling services provided by Primary Therapeutic Services, RLLP, a company he owned. According to the indictment, the OHCA reimbursed Bradley for counseling five minors who turned out to be his niece and nephews. Regulations and ethical rules governing licensed professional counselors prohibit the counseling of family members. Consequently, Medicaid regulations prohibit reimbursement for counseling family members. Between Oct. 31, 2013, and July 30, 2017, Bradley caused the OHCA to pay fraudulent counseling claims totaling $182,732.12.

Bradley pleaded guilty to one count of health care fraud on March 13, 2018. He agreed to pay $182,732.12 in restitution, partly to SoonerCare via the OHCA and partly to the federal Centers for Medicare and Medicaid Services. To date he has paid $46,000 of this amount.

On Sept. 25, Chief U.S. District Judge Joe Heaton sentenced Bradley to 24 days in jail during weekends. In addition, Bradley will be on probation for five years.

This case is the result of an investigation by the Medicaid Fraud Control Unit of the Oklahoma Attorney General’s Office. It was prosecuted by Assistant U.S. Attorney Amanda Green and Assistant Oklahoma Attorney General Lory Dewey, who also serves as a Special Assistant U.S. Attorney.

Reference is made to court filings for further information.

Source: U.S. Department of Justice, Office of the United States Attorneys

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