OKLAHOMA CITY – A mother and a son pleaded guilty to defrauding Medicaid out of nearly $770,000.
Yesterday, officials say Deborah Gray, 60, and her son, Keith Gray, II, 26, both of Oklahoma City, pleaded guilty to three counts of health care fraud in connection with submitting false claims to Medicaid for behavioral health counseling services.
According to Mark A. Yancey, United States Attorney for the Western District of Oklahoma, on July 6, 2016, Deborah Gray and Keith Gray were indicted on 151 counts of health care fraud.
The indictment alleged that from October 2011 through May 2014, Deborah Gray owned and operated a business called DAG Counseling Services, PLLC.
DAG Counseling held itself out as providing behavioral health counseling services to Medicaid-eligible children.
It is alleged that Keith Gray was employed by DAG Counseling.
It was alleged that the Grays devised and executed three schemes to defraud Medicaid through DAG Counseling.
First, it is alleged that the Grays submitted or caused to be submitted to Medicaid claims for “targeted case management services” for periods of time when the children were actually being transported between home or school and the DAG Counseling offices, in violation of Medicaid regulations.
Second, it was alleged that the Grays submitted or caused to be submitted to Medicaid claims for one-on-one “psychosocial rehabilitation services” that exceeded the billing maximum of 90 minutes per child per day, in violation of Medicaid regulations.
Finally, it was alleged that the Grays submitted or caused to be submitted to Medicaid claims for one-on-one “psychosocial rehabilitation services” that (a) were not actually provided, or (b) were actually provided in groups of two or more children, or (c) were provided for less time than was billed to Medicaid.
Deborah Gray and Keith Gray each admitted to one count of executing each of the three schemes.
As part of their plea, the Grays agreed to pay restitution to Medicaid in the amount of $769,578.38.
At sentencing, the Grays face up to 10 years in prison, three years of supervised release, and a $250,000 fine on each count.
A sentencing date will be set by the court in approximately 90 days.