A former north Arkansas social worker pleaded guilty Tuesday to fraudulently billing Medicare for more than $71,000 worth of counseling sessions he never performed.
Thomas Craig Burns, 59, appeared before U.S. District Judge D. Price Marshall Jr. at the federal courthouse in Little Rock and said he chose to plead guilty to a charge of health care fraud because he didn’t want to go through the months or years needed to stand trial for something he did.
“I did what I did, and I’d like to be accountable for it,” said Burns, who operated a private practice in Mountain Home known as Road Less Traveled Counseling.
According to federal court papers, Burns “consistently” billed Medicare daily for more than 12 hours of faceto-face counseling sessions with patients. The sessions were the most costly service for which he could bill Medicare within his specialty, and they made up “99.99%” of his billing between Jan. 1, 2008, and Dec. 31, 2012.
On Tuesday, Burns admitted that many of those counseling sessions never occurred.
In total, Burns admitted to fraudulently receiving Medicare reimbursements of $71,305.15, which he is required to pay back to the government as part of his plea agreement.
The amount is less than half what Burns billed the federal program in 2012, according to data obtained by The Wall Street Journal that were published last year as part of the newspaper’s “Medicare Unmasked” series. The data were the first of their kind to be made public after the Journal took legal action against the federal Centers for Medicare and Medicaid Services.
According to the data, Medicare paid Burns more than $160,000 in reimbursements for 2,900 sessions involving 31 patients that year.
During the hearing, Assistant U.S. Attorney Alex Morgan noted that Burns’ billing at times resulted in impossible circumstances. For instance, Burns submitted bills for 62.25 hours of one-on-one therapy sessions all for one day, Aug. 2, 2012.
But court records show that neither Medicare nor its contractor initially spotted the unusual billing patterns and alerted federal authorities.
The federal investigation that led to Burns was started by one of his patients, who made a complaint to AdvanceMed, a Medicare contractor. In July 2012, the patient reported to the contractor that Burns had billed Medicare for services that he never provided to her.
According to Burns’ plea agreement, the patient received one therapy session in 2011 and decided not to go back. But between Jan. 20, 2011, and Nov. 26, 2011, Burns billed for 190 counseling sessions under the woman’s name. As a result, Medicare paid Burns more than $10,664.94.
When confronted by federal agents, Burns admitted to “sometimes” billing for services he didn’t provide. At the time, he said he was overwhelmed “with marital problems, episodic drug use and depression,” according to his plea agreement.
Documents from social worker licensing boards in Texas and Arkansas show that Burns had previously had problems with substance abuse, and his struggle led to his license being revoked in Texas in the late 1990s.
Records from the State Board of Social Worker Examiners in Texas show that Burns was placed on probation in 1996 for abusing one of his client’s prescription drugs. His license was later revoked in 1998, shortly after he went to prison on a felony conviction in Harris County, Texas, for fraud involving a controlled substance.
According to the Texas Department of Criminal Justice, Burns served about eight months of a two-year prison term beginning in December 1997.
Burns completed parole and moved to Arkansas where, in 2001, the Arkansas Social Work Licensing Board, which oversees private social workers, granted him a provisional license and placed him on probation because of his history in Texas.
The board placed Burns on probation again in 2004 and required him to submit to drug screenings and other substance-abuse counseling. Board records show he met all the conditions of the probation, at least until it concluded in 2006.
In August 2013, the board revoked his license, citing regulatory violations including negligent or fraudulent practice, failing to keep proper documentation, and giving or receiving any “compensation for professional services not actually or personally rendered,” according to a summary of the disciplinary decision.
The board also found that Burns violated parts of the board’s ethical code, including that social workers shouldn’t exploit relationships with clients, students or subordinates for personal gain.
On Tuesday, Burns was allowed to remain free on bond. He is to be sentenced Sept. 9 and faces up to 10 years in prison.