Industrial-Scale Fraud in Minnesota Medicaid Programs
Federal prosecutors have filed a new round of fraud charges against providers of Medicaid-funded programs administered by the state of Minnesota, shedding light on the staggering scale of theft taking place under the watch of state agencies. At a news conference announcing charges against six individuals who allegedly defrauded the state of more than $10 million in various schemes, Assistant U.S. Attorney Joe Thompson stated that he believed “a significant amount” of the $18 billion paid out by 14 “high-risk” Medicaid-funded programs since 2018 was lost to fraud — possibly half or more.
Fraud Schemes and Charges
New charges filed include cases against one person accused of defrauding state autism services and five more individuals tied to the Housing Stabilization Services program, which helped people with disabilities and addiction issues at risk of homelessness pay for housing. Thompson described one of the new housing stabilization cases as an instance of “fraud tourism,” where two defendants from Philadelphia who had no connections to Minnesota were drawn to the program after hearing it was “easy money.”
Anthony Waddell Jefferson, 37, and Lester Brown, 53, established a business in Minnesota to collect Medicaid payments from the Department of Human Services, though neither lived in the state, according to federal prosecutors. Both are accused of collecting $3.5 million for services never provided and are charged with wire fraud. The Minnesota U.S. Attorney’s office also announced new wire fraud charges against Hassan Ahmed Hussein, 28, and Ahmed Abdirashid Mohamed, 27, who allegedly claimed $750,000 for services through their company, Pristine Health, LLC, but only used a fraction for services.
Cash Kickback Payments and Explosive Growth
Kaamil Omar Sallah, 26, was charged with wire fraud for allegedly making more than $1.4 million in fraudulent claims through his company SafeLodgings. Abdinajib Hassan Yussuf, 27, is accused of stealing through the Early Intensive Developmental and Behavioral Intervention benefit, a program meant to support people under 21 with autism. Yussuf, of St. Cloud, is accused of using his company, Star Autism Center, to submit millions in inflated and fraudulent claims for services never provided. Federal prosecutors allege that Yussuf and partners would recruit children and seek out autism diagnoses and approach parents with offers of cash kickback payments for enrolling their children in the program.
Ultimate Home Health Services, a Bloomington-based provider of “Integrated Community Services,” is under investigation for a new fraud scheme. The Medicaid-funded program helps people with disabilities live in a home rather than an assisted living facility, and it’s one of the 14 the state has identified as “high-risk.” The program has seen “explosive growth” since it started in 2021, with payouts increasing from $4.6 million to $170 million in just one year. The state has paid out more than $400 million in Medicaid reimbursements since the program started, according to prosecutors.
Conclusion and Call to Action
Thompson stated that he believed the scale and type of fraud occurring in Minnesota was unique and had been “allowed to go on far too long.” He emphasized that the state had not done a good job of overseeing Medicaid programs and that it was time for the state to grapple with the issue. For more information on this developing story, visit Here
Image Source: www.twincities.com
