MINNEAPOLIS (FOX 9) - Three people were charged on Thursday in an alleged scheme to defraud Minnesota’s Medicaid program, according to Minnesota Attorney General Keith Ellison.
The charges allege the three men swindled Medicaid out of nearly $11 million, which is the largest fraud prosecution charged by the Minnesota Medicaid Fraud Control Unit, according to Ellison's office.
The head of the alleged scheme, Abdirashid Ismail Said, is charged with one count of racketeering, eight counts of aiding and abetting theft by swindle, and one count of perjury for defrauding the Medicaid program through his operation of three Medicaid-funded home health care agencies: Faym Health, Prestige Health and Minnesota Home Health Care.
Two others involved in the alleged scheme, Ali Abdirizak Ahmed and Said Awil Ibrahim, were each charged with racketeering and aiding and abetting theft by swindle.
The Minnesota Attorney General's Office alleges that the defendants billed Medicaid for services that were not eligible for payment. They also billed for waivered services that were not documented or were based on fraudulent documents, in addition to billing for services not provided at all.
Court records indicate Said was convicted of Medicaid fraud in 2022, and he was ordered to pay the state of Minnesota $77,000. Ellison said he was then barred from working with any Medicaid-funded agency.
Minnesota law prohibits Said’s agencies from receiving any Medicaid funds at all, but the agencies received over $10.9 million while Said operated them without disclosing involvement, charges allege.
According to the charges, investigators interviewed a case manager at Faym Health, and she said she created fraudulent documentation for recipients and worked at the agencies. The case manager stated Said and his co-conspirators knew the documentation was fraudulent, and she was paid to create it. The charges allege evidence shows the case manager received $73,000 from Faym Health.
Further investigation shows that Faym Health was paid over $4.6 million for services based on this fraudulent documentation, court documents said.
Investigators found Said and his co-conspirators billed $997,000 for clients who denied receiving services, court documents allege. They also overbilled for over $300,000 and billed over $5.8 million for services that were not documented or were fraudulently documented.
Four others have been previously charged as part of this investigation, and additional charges are expected, the Minnesota Attorney General’s Office said.
"Minnesotans who receive Medical Assistance have a right to expect that they’ll receive all the care, dignity, and respect they’re entitled to. 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," said Ellison in a written statement.