Minnesota Attorney General Keith Ellison recently announced the largest-ever Medicaid fraud prosecution by his office, charging three individuals with defrauding the Minnesota Medical Assistance (Medicaid) program of nearly $11 million.
Abdirashid Ismail Said, 48, the principal actor, faces multiple charges, including racketeering, theft by swindle, and perjury for operating three Medicaid-funded home healthcare agencies.
Said’s alleged co-conspirators, Ali Abdirizak Ahmed, 37, and Said Awil Ibrahim, 24, are also charged in Hennepin County District Court with racketeering and aiding and abetting theft by swindle.
“Minnesotans who receive Medical Assistance have a right to expect that they’ll receive all the care, dignity, and respect they’re entitled to,” said Attorney General Ellison. “Minnesotans trying to afford their lives have a right to expect that every one of their tax dollars will be put to use properly.
“People who commit Medicaid fraud violate both of those rights. My office is working aggressively to hold them accountable and will keep doing so.”
In 2022, Said was convicted of Medicaid fraud, ordered to repay the State $77,000, and barred from working with any Medicaid-funded agency. Following his conviction, other agencies operated by Said billed the Medicaid program for providing both home and community-based waivered services and personal care assistant (PCA) services.
Faym, owned by Ahmed, and Prestige, owned by Ibrahim, billed the Medicaid program for providing home and community-based waivered services. Minnesota Home billed the Medicaid program for providing PCA services.
MFCU Investigators interviewed a designated coordinator and manager at Faym who admitted that she created fraudulent documentation for both recipients and workers at the agencies. She further stated that Said and his co-conspirators knew the documentation was fraudulent, and that she was paid to create it.
Based on the fraudulent documentation reviewed and the designated coordinator’s statements, MFCU investigators determined that Faym was paid over $4.6 million for services based on this fraudulent documentation.
The investigation also found that the agencies routinely billed for services not provided at all, for more services than documented in employee timesheets, and for PCA services that were not supervised by a qualified professional (as required by Minnesota law).
Often these findings resulted from workers or clients who said they did not receive any services from the agencies, despite the agencies billing for services provided to them.
MFCU investigators found that, between all of the agencies, Said and his co-conspirators billed $997,000 for recipients who denied receiving services, overbilled for over $300,000, and billed over $5.8 million for services that were not documented or were fraudulently documented.
From May 2019 to May 2023, the three owners and their agencies often wrote large checks and transferred funds between each other without any legitimate business purpose.
Furthermore, during a probation violation hearing related to his prior conviction, Said testified under oath that he did not have any ownership, management, employee or contractor role at any of the agencies. Based on the voluminous digital evidence, including frequent text messages from Said to the agency owners, employees, or clients about Medicaid-funded services, these statements were false.
Four other people have been previously charged as part of this investigation. Additional charges are expected against other individuals, including owners and employees of other agencies, as the investigation continues.
This case resulted from a collaboration between the MFCU in the Office of Minnesota Attorney General Keith Ellison and the Department of Health and Human Services’ Office of Inspector General (DHHS/OIG), with support from the Minnesota Commerce Fraud Bureau and the Minnesota Department of Human Services’ Forensic Lab.
“Individuals who seek illicit gains from Medicaid do so to the detriment of those beneficiaries who rely on the continued solvency and integrity of these vital federal health care programs,” said Mario M. Pinto, special agent in charge of the U.S. Department of Health and Human Services, Office of Inspector General.
Information provided in part by the Office of Minnesota Attorney General Keith Ellison
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??? Who’s surprised