Federal authorities say a Maryland health care assistant has pleaded guilty to Medicaid fraud.
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A home aide could spend years in prison after billing Medicaid for thousands of hours he never worked — costing the program more than $730,000, federal prosecutors say.
That includes 3,400 hours he spent traveling internationally instead of caring for Washington, D.C. residents, which he claimed he did on submitted timesheets, court documents show. As a result, Medicaid was billed $70,100 for services the man did not provide during the trips to Europe and Africa.
A medical assistant from Lanham, Maryland, pleaded guilty to health care fraud on Monday, Nov. 28, after defrauding the DC Medicaid program of $733,405, which he agreed to repay, the U.S. Attorney’s Office for the District of Columbia said in a news release.
After billing Medicaid for hours he never worked, he was directly paid $396,155 between 2015 and 2021, according to court documents. He submitted false time sheets claiming to help 17 D.C. residents with personal care, including clothing, bathing, meals and more, prosecutors said.
The man will also pay back $396,155 in ill-gotten gains, prosecutors said. That was after he admitted the money was missing, court documents said.
An attorney representing the man declined a request for comment from McClatchy News.
He will likely be sentenced to more than two years in federal prison, according to the release.
Scheme
According to prosecutors, while the man was hired as a personal care assistant and worker referred to the participant, he did not work as much as he said he would.
One person he used to care for told investigators the man came to his home on weekends for eight hours a day, prosecutors said. However, “at some point (he) disappeared” and never appeared again, the complaint said.
Another resident he cared for told law enforcement that the man had been his housekeeper for one year and would not be working over the Christmas holidays, according to the complaint.
But Medicaid records showed the man allegedly provided care services to the person “nearly every day from November 2015 through September 2019, including Christmas in 2015, 2016, 2017 and 2018,” the complaint said.
In addition to being caught recording his travel time during business hours, the man billed Medicaid for 24 hours of work he claimed to have done in one day — 156 separate times, according to the release.
On hundreds of other days, the man submitted time sheets that said he worked more than 16 hours a day caring for at least two Medicaid beneficiaries, the complaint said. But these report cards took into account the time that overlapped.
Since 2018, 12 former health care workers have pleaded guilty to Medicaid fraud, including a man, the release said.
There are about 82 million people in the US covered by the program.
Prosecutors are asking anyone with knowledge of health care fraud to contact the Department of Health and Human Services’ Office of Inspector General hotline at 800-HHS‑TIPS (800-447-8477) or the D.C. Office of the Inspector General at 800-724-TIPS (800-274-8477).
Lanham, where the man is from, is about 15 miles northeast of Washington, DC
