Two Maine men have been indicted on federal charges of defrauding the MaineCare health care program and with soliciting and receiving health care kickbacks over a roughly two-year period, federal prosecutors said. Both pleaded not guilty on Tuesday.
The U.S. Attorney’s Office in Maine said a federal grand jury indicted Abdirashid Ahmed, 38, of Lewiston and Garat Osman, 32, of Auburn for allegedly getting kickbacks of up to $200 per referral of people to a specific health care provider.
Ahmed solicited kickbacks from a MaineCare provider in exchange for referring beneficiaries to the provider, according to the indictment. Ahmed and Osman also allegedly brought beneficiaries to the provider and served as Somali interpreters during the visits.
The indictment also alleges that the health care provider, identified in documents as “Individual A,” submitted fraudulent bills for interpreting services for patients’ appointments with the provider.
According to court documents, Ahmed is accused of receiving at least $23,700 in kickbacks for referring patients to the health care provider between November 2015 and last December. According to court filings, Osman received nearly $7,000.
The indictment said that the health care provider’s bills indicated that interpreting services were provided for about two hours when the appointments were actually much shorter, usually about half an hour. MaineCare reimburses for interpreting services at a rate of $20 for each 15-minute interval.
Ahmed operated three companies offering interpreting services and Osman worked for one of them, the indictment said.
The indictment said the government will seek to have Ahmed and Osman forfeit the allegedly illegal kickbacks. The name of the health care provider is not included in the indictment.
Ahmed and Osman were arrested Tuesday morning and both entered not guilty pleas at separate hearings in U.S. District Court in Portland. A trial was initially set for June. They were being held in custody until Monday, when they will reappear in court for detention hearings.
If convicted, Ahmed and Osman each face up to 10 years in prison, three years of supervised release and a $250,000 fine. If convicted, each may also be ordered to pay restitution to MaineCare.
Assistant U.S. Attorney Daniel J. Perry said Tuesday he couldn’t comment on whether additional charges may be coming and whether more arrests may occur in this case.
The investigation is being conducted by the FBI, the U.S. Department of Health and Human Services’ Office of the Inspector General, and the Medicaid Fraud Crime Unit of the Maine Attorney General’s Office.
Staff Writer Christopher Williams of the Sun Journal contributed to this report.
Send questions/comments to the editors.
