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Medicaid fraud charges filed after scheme uncovered
Minnesota officials believe that two Medicaid fraud cases filed this week could add up to nearly $3 million in losses for taxpayers found by the state’s Medicaid Fraud Control Unit, which has about 220 open cases and is set to grow by nearly 50% with new funding from the legislature. FOX 9’s Corin Hoggard has the details.
ST. PAUL, Minn. (FOX 9) - Minnesota's Medicaid Fraud Control Unit charged nine people with fraud this week, with two cases standing out for the scale of the alleged schemes.
Psychotherapist accused of $2.25 million in false claims
What we know:
Duluth-based psychotherapist Peter Meilahn is accused of bilking Medicaid and taxpayers out of $2.25 million, according to fraud investigators.
He faces 11 counts of felony theft for allegedly submitting more than 27,000 false claims for behavioral health services between 2019 and 2026. He also faces two counts of identity theft for allegedly using the names of patients he never saw — including all seven children in one family.
"None of them ever had a single appointment with Meilahn, but we allege that he submitted claims providing two years’ worth of services for all seven children, receiving over $150,000 for these non-existent services," said Minnesota Attorney General Keith Ellison.
Prosecutors at the attorney general's office say they found billing for 15 people who never received services from Meilahn, totaling $740,000.
Investigators also noticed a major red flag in his billing records: 468 days where he submitted claims for more than 24 hours of work. UCare eventually referred him to the fraud unit.
Home care business accused of billing for services that never happened
Dig deeper:
Awo Mohamed faces similar accusations, but tied to home care services that investigators say never took place.
Her business, Always On Time, allegedly billed almost $700,000 for more than 20,000 fraudulent hours. In some cases, investigators say the person supposedly receiving home care was in jail or a hospital at the time the services were billed.
Investigators are working to recover some of the money lost in both cases.
"There are some cases here where we've been able to locate a number of bank accounts from people that we believe may still have money in them," said Nick Wanka of the Medicaid Fraud Control Unit.
Fraud detection improving, unit set to expand
Why you should care:
Investigators say people and agencies are getting better at catching fraud, with about 220 open cases currently active.
Wanka pointed to improvements in how billing anomalies are being monitored and acted on.
"I think there have been some improvements over the years about how they're monitoring those type of things," Wanka told FOX 9. "And when they flag it and then when they say, hey, this is an anomaly in billing, we're going to cut off payments here, we're going to investigate this and we're going to refer this over to law enforcement."
What's next:
The Medicaid Fraud Control Unit is set to grow by nearly 50% with new funding from the legislature this year, adding 11 investigators and three attorney, plus four staffers. Mohamed has already made a court appearance.
What we don't know:
It is not yet clear how much of the allegedly stolen money investigators will be able to recover or what the full outcomes of the court proceedings will be for either Meilahn or Mohamed.
The Source: FOX 9's Corin Hoggard reported live from the attorney general's office. Information is based on charges filed by the Minnesota Medicaid Fraud Control Unit and statements from Attorney General Keith Ellison and Medicaid Fraud Control Unit investigator Nick Wanka.