Pair denies taking kickbacks, overbilling MaineCare in alleged health care fraud

[Deeq A.]

Two Androscoggin County residents accused of receiving more than $27,000 in kickbacks for medical referrals and of overbilling MaineCare for interpreter services pleaded not guilty Tuesday to health fraud charges in U.S. District Court in Portland.

Abdirashid Ahmed, 38, of Lewiston and Garat Osman, 32, of Auburn, were indicted Friday on one count each of conspiracy to commit health care fraud, conspiracy to defraud the U.S. and to pay and receive health care kickbacks, and six counts each of receiving health care kickbacks.

The scheme allegedly was perpetrated from May 2015 through December 2017. The duo received $200 per referral, the indictment alleged.

Ahmed solicited kickbacks from a MaineCare provider, who is not named in court documents, in exchange for referring beneficiaries to the provider, according to a press release issued by the U.S. attorney’s office. Then, Ahmed and Osman allegedly brought people who received MaineCare to the provider and served as Somali interpreters during the visits.

The pair allegedly submitted fraudulent bills to MaineCare. Both defendants own or are part owners of interpreting services, the indictment said.

MaineCare pays interpreters $20 per 15 minutes of interpreting, according to the indictment. Both are accused of overbilling for more than an hour of interpreting per visit when the visits did not last that long. The total amount they allegedly overbilled is not included in court documents.
Attorneys for the men declined to comment on the case.

On Tuesday, Ahmed and Osman were ordered held temporarily without bail until a judge can determine if there are conditions under which they can be released pending the resolution of their cases.

If convicted, each faces up to 10 years in prison and a $250,000 fine. They also could be ordered to pay restitution.

Source: – BDN