Oklahoma Law

Patient Abuse and Medicaid Fraud Hurt Health Providers and Vulnerable Patients

From a legal and ethical perspective, health providers in hospitals, long-term care facilities, and hospice are in a unique position to assist in preventing and reporting patient abuse and Medicaid fraud.  Providers of qualilty health care to vulnerable patients owe it to their professions and patients to be vigilant in prevention and reporting to authorities who can take action.  The successful prosecution of these crimes depends on it.

Patient abuse has been successfully prosecuted as a result of ineffective pain management and failure to provide palliative care to patients who suffer distress which could be relieved.  Palliative care should be considered "treatment" even when a cure is not available.

Refusal of health providers to honor the wishes of patients in advance directives for health care, particularly in regard to requests fo rpain management rather than aggressive "treatment" which may be both painful and futile is also unlawful. 

In Oklahoma recent Medicaid fraud prosecutions have included the owner of a Mustang medical supply business will pay almost $132,000 in restitution after pleading guilty to filing bogus Medicaid claims, Attorney General Drew Edmondson said.

Thomas J. Charlebois, Jr., pleaded guilty in Oklahoma County District Court to one count of Medicaid fraud for allegedly billing the Oklahoma Medicaid Program for medical supplies he did not deliver. He was sentenced to a five-year suspended sentence and ordered to pay $131,993.67 in restitution, a $1,000 fine, court costs and $100 victim compensation assessment.

Charlebois, the owner of Charlebois Medical Systems, was charged Jan. 24 by the attorney general’s Patient Abuse and Medicaid Fraud Control Unit.

In 2007, one such case was filed in March against Dr. Patrick Fahey. The unit alleged Fahey provided his patients with prescription drugs without medical basis, and then submitted false claims to Medicaid and Medicare for reimbursement for those drugs. Fahey pleaded guility to the charges in June and was ordered to pay more than $13,000 in investigative costs along with fines, court costs and serve a suspended sentence.

A second case that came to a close in 2007 involved a man who said he had been given legal power of attorney over his father’s assets. Dr. William Edward Clymer was charged Dec. 13, 2005, in Pawnee County District Court after investigators found he had forged a power of attorney form from his father. Additionally, investigators alleged he filed and settled a lawsuit on his father’s behalf without his father’s knowledge.

Clymer pleaded no contest to the allegations and was sentenced to a five-year deferred sentence and ordered to pay $300,000 in restitution.

The Oklahoma Attornoey General's Patient Abuse and Medicaid Fraud Control Unit has statewide jurisdiction to investigate and prosecute provider fraud and patient abuse and neglect in any Medicaid provider facility. Anyone with information regarding provider fraud or patient abuse can contact the Attorney General’s Office at (405) 521-4274.

Why advance planning for end-of-life heath care is important for Oklahomans:

With advancement in medical technology, life-sustaining treatments are available that could maintain many of us far longer than we may personally consider meaningful life. Meaningful life is defined by one's own values and beliefs.

Autonomy, usually through informed consent or refusal, is an established principle of the law and ethics. It allows a competent adult to accept or reject any offered health care treatment. The problem is that when the time comes to make these decisions, many of us may not have the capacity to make our wishes known.

Capacity to make treatment decisions means an individual is able to understand the relevant information, reflect on it in accordance with his or her values, and communicate a decision to caregivers.

To provide some direction to health providers, Oklahoma law presumes that we would want to be resuscitated in the event our heart stops beating or we stop breathing.  It also presumes we would want to be fed through a tube inserted into the stomach in the event we could not eat and drink naturally by mouth.   These legal presumptions protect those of us who want these medical interventions.  But for those who do not wish to have these measures and who are unable express the wish to refuse resuscitation or refuse to be fed through a tube, the burden is on them to make and communicate our wishes before we loose capacity to do so.

How to make your wishes known:

In Oklahoma, there are four legal tools for advance planning which set out individual healthcare decisions. They are:

1. Advance Directive for Health Care;
2. Durable Power of Attorney for Health Care;
3. Do-Not-Resuscitate Consent; and
4. Guardianship of the Person.

The OPCRC website will provide ongoing information regarding Oklahoma law and legal forms related to advance planning.

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