Last Thursday, the largest health care fraud takedown in Washington, D.C. history resulted in the arrests of more than 20 people, from operators of home care agencies to officer workers and personal care assistants.
The investigation uncovered various, separate schemes involving fraud, kickbacks and false billings for D.C. Medicaid patents.
In one alleged scheme, the owner of three home care agencies, who was barred from participating in federal health care programs after her nursing license was revoked, is accused of collecting more than $75 million through the District of Columbia and Maryland Medicaid programs.
In another scheme, individuals are accused of recruiting and teaming up with Medicaid beneficiaries, who allegedly faked or exaggerated symptoms so they could sign up for home health services.
It is alleged that these individuals then received cash payments of approximately $200 every two weeks to sign falsified time sheets stating that they received home care services when they did not.
Lastly, another alleged fraud instance involves a woman accused of selling counterfeit home health care aide certificates.
“This investigation has revealed that Medicaid fraud in the District of Columbia is at epidemic levels,” stated U.S. Attorney Ronald Machen, Jr. “This fraud diverts precious taxpayer dollars, drives up the cost of health care, and jeopardizes the strength of a program that serves the most vulnerable members of our society.”
Twelve defendants were named in a total of five indictments that were unsealed in the U.S. District Court for the District of Columbia.
An additional 13 defendants were charged in the Superior Court of the District of Columbia with first-degree fraud.
The investigation was spearheaded by the Federal Bureau of Investigation’s Washington Field Office and the Department of Health and Human Services Office of Inspector General.
“Criminal organizations that steal from the District of Columbia Medicaid program are robbing the bank of health care money and cheating honest citizens of resources needed for their care,” said Special Agent in Charge Nicholas DiGiulio in a statement. “We will work tenaciously with our law enforcement partners to fully investigate these disturbing allegations.”
Written by Jason Oliva