A former north Arkansas social worker was sentenced to a year in prison Wednesday for bilking Medicare out of more than $71,000.
Thomas Craig Burns, 59, also was ordered by U.S. District Judge D. Price Marshall Jr. to pay restitution for fraudulent payments he received from the Centers for Medicare and Medicaid Services for counseling sessions he never performed.
Burns' sentencing concluded an investigation that uncovered not only the $71,305.15 in fraud to which he pleaded but also years of suspicious Medicare billings submitted from his Mountain Home private practice known as Road Less Traveled Counseling.
On Wednesday, Burns' public defender, Molly Sullivan, argued for a sentence of probation for her client, saying he already is suffering because of his crime -- living in a homeless shelter, losing contact with his daughter and working as a cook at a pizza place despite having a master's degree.
"He has been absolutely stripped of everything," Sullivan told Marshall.
But Assistant U.S. Attorney Angela Jegley dismissed Sullivan's argument, saying that many things Burns considered punishment are everyday life for many people.
Jegley noted that Medicare fraud is a breach of public trust, and the government supported a sentence of 21 months to 27 months as recommended by federal sentencing guidelines.
The multibillion-dollar Medicare system can't audit each claim it receives, she said, resulting in many claims being paid on good faith. Burns abused that good faith, Jegley said, noting the type of fraud Burns committed easily can go undetected.
"This sort of fraud, when it is committed, is insidious and can continue to exist for a long amount of time," Jegley said.
According to court papers and other documents obtained under the Arkansas Freedom of Information Act, Burns left a paper trail of suspicious billings over a period of years.
He billed for counseling sessions with dead patients and 62 hours of one-on-one counseling in one day.
He billed for several straight weeks of 12-hour days, including some in which he claimed to work more than 24 hours. And 99.99 percent of the time, he billed for the most costly service he could provide.
The billings added up so much in 2012 that Burns received the most Medicare payments of any similarly qualified social worker in Arkansas.
He also ranked 10th in payments out of 13,000 social workers nationwide, according to federal data published by The Wall Street Journal.
Between 2008 and 2012, Burns billed Medicare for $2.5 million and was paid more than $500,000, according to an investigation conducted by a Medicare benefit integrity contractor.
But in summer 2012, a patient complaint sparked a federal investigation.
In June, Burns pleaded guilty to one count of health care fraud, a charge that carries a 10-year maximum prison sentence and bars him from billing the Medicare program.
During the hearing Wednesday morning, Burns told Marshall that he was willing to face the consequences for his crime and would accept the judge's ruling if he deemed prison necessary. But Burns, who has struggled with substance abuse in the past, said he has worked hard over the past several months to turn his life around.
Burns said he wished to remain free and maintain the progress he's made since living at Our House, a Little Rock homeless shelter that requires its residents to be employed, abide by certain rules and save a portion of their income.
"It would be harder to not go [to prison]," Burns said. "I would like to keep on the path I'm on, keeping my responsibility and continuing to rebuild my life.
"I'm ashamed about what I did. Every day I'm reminded of what I did. This whole process is about what I did. There are no excuses. I have none."
In ordering the prison time, Marshall said he commended Burns for taking responsibility for his crime and for the progress he's made over the past several months.
Marshall deemed a sentence of 21 months to 27 months too harsh, but the judge said the seriousness of the crime required prison time. Marshall said Medicare fraud is in some ways an "easier" crime to commit because the perpetrator isn't physically taking money from someone, as in a purse snatching or armed robbery.
"Here it's just the great government money in the sky. But that's all of our money, and it's needed to provide health care," Marshall said in ordering the 12-month prison sentence.
The judge ordered Burns to report to federal prison by Oct. 30. He will be on supervision for one year after his release.
Metro on 09/10/2015