Maine: Somali pair convicted in medicaid fraud case

Your tax dollars:

From the Sun Journal (hat tip:  Susan):

LEWISTON — An Auburn man and a Portland woman were convicted Thursday of defrauding the federal government of tens of thousands of dollars in Medicaid money, according to the Office of the U.S. Attorney in the District of Maine.

The scheme likely was linked to the raid of a Lewiston office building by federal officials a year ago.

Ahmed Yusuf Guled, 75, of Auburn and Dahabo Abdulle Osman, 59, of Portland were found guilty after a nine-day jury trial in U.S. District Court in Portland, according to federal prosecutors.

Guled was convicted of 16 counts; Osman, 9.

Each of them was convicted of three counts that carry 10-year maximum prison sentences apiece. The remaining counts have maximum terms of five years apiece. Each of the counts carries a maximum fine of $250,000.

The couple was found guilty of conspiring to defraud the federal government and commit health care fraud offenses by obtaining Medicaid money in connection with MaineCare’s Home and Community-Based Care Program, also known as the Waiver Program.

Readers, this form of health care fraud is going on everywhere.  We first learned about it in this story on Minneapolis.  Here is basically how it works:

Under this program, MaineCare members, who are assessed at a nursing home level of care, may choose to get personal care services and skilled nursing services at their homes instead of at a nursing home or similar institution.

Prosecutors introduced evidence at trial that showed Guled, with the help of his adopted sister [adopted sister, my foot!-ed], Osman, deceived nurse assessors contracted by the state into believing that he was eligible for care at a nursing home.

For that reason, Osman was paid wages as his personal care assistant. Those wages were reimbursed by Medicaid through three separate home health agencies. The evidence showed that the services weren’t medically necessary and that Osman didn’t provide all of the services billed by the home health agencies.

Read the whole story.

The most intriguing aspect of all this to me is where are they (African refugees, esp. Somalis) learning how to do these health care scams.  I know the SEIU (Service Employees International Union) is organizing home health workers, but could they be teaching how to rip off the taxpayer?

For new readers, more Somalis are on the way:

The US State Department has admitted over 80,000 Somali refugees to the US (this linked post continues to be one of the most widely read posts we have ever written) in the last 25 years and then in 2008 had to suspend family reunification because widespread immigration fraud was revealed through DNA testing.  That specific program has not yet been reopened (that we know of), but will be soon.

Nevertheless, thousands of Somali Muslims continue to be resettled by the State Department as I write this. We recently learned that we will be taking 6000 Somalis this year from one camp in Uganda and as many as 11,000-13,000 total from around the world.

Through the Refugee Resettlement program alone 2657 legal Somalis have already arrived in this fiscal year (2010) as of May 30th with an unknown number arriving through other legal programs and  illegally across both our borders.

Be sure also to read this Comment Worth Noting from a Somali woman who refers to the Somali influx as an “invasion” and says they have no plans to assimilate.

Somalis disturbingly call their immigration to certain countries or cities as “invasions” and they call cities with no or little Somali populations as “Tuulas” or “villages”….

I think Lewiston, ME has probably gone beyond being a Tuula!

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