Two convicted of Medicaid fraud

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.

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, 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.

The indictment alleged that MaineCare (Maine's Medicaid program) paid out more than $61,000 because of those false claims.

Osman was paid more than $41,000 from the home health agencies, most of which was deposited into bank accounts controlled by Guled.

Guled and Osman also were convicted of health care fraud and Guled was convicted of four counts of making false statements in connection with a health care benefit program.

Both were convicted of making false statements to the Social Security Administration in connection with the review of their Supplemental Security Income (SSI benefits) and to housing officials with respect to public housing benefits. In addition, the couple was convicted of theft of government funds, including Social Security and federal welfare benefits. Guled also was found guilty of making false statements in connection with the welfare benefits.

Guled failed to disclose bank accounts and Osman failed to disclose the wages she was paid as a personal care assistant when the couple met with federal agency workers, prosecutors showed at trial.

U.S. Attorney Paul Silsby praised several federal agencies for their work in bringing the case to trial successfully.

In order to make comments, you must verify your account.

In order to comment on SunJournal.com, you must use your real name and include the town in which you live in your profile. A member of our staff will call you to verify this information. To join in, fill out your user profile completely and check the box "please verify my status." We'll get back to you within one business day to verify your account.

Login or create an account here.

Our policy prohibits comments that are:

  • Defamatory, abusive, obscene, racist, or otherwise hateful
  • Excessively foul and/or vulgar
  • Inappropriately sexual
  • Baseless personal attacks or otherwise threatening
  • Contain illegal material, or material that infringes on the rights of others
  • Commercial postings attempting to sell a product/item
If you violate this policy, your comment will be removed and your account may be banned.

Advertisement

Comments

BillTheGorilla's picture
verified

These people are abusing

Luckily, it's all so simple. "These people" are all exactly the same, so if one does something wrong you can reasonably conclude that all have done or will do something wrong. Oh wait a minute, there's a mistake in the logic here. If the assumption is wrong, the conclusion has not been demonstrated. And the assumption is wrong. They're not all the same. Actually, it's only the ones who were shown to have done something wrong, not all. So MAYBE IT'S NOT SO SIMPLE!

vzep's picture

Abuse

These people are abusing the very system that is helping them to survive here. It shows a
total lack of respect. Deportation will set a much needed example.

tron's picture

I was unaware that

Auburn and Portland are now part of Somalia.

Pirate's picture
verified

Hey, what about Loiston?,

Hey, what about Loiston?, said the parrot.

thinkingman's picture

Technically most of our

Technically most of our somalian community came here from Atlanta Georgia as part of the refugee resettlement program...federal money to allow them to find a better place to live - I've heard the subsidized housing in Atlanta has pretty dangerous conditions, poor schools and people there felt unsafe.

swhite1978's picture
verified

enough is enough

I just want to say that everyday when I come online to read the paper I see insults back and forth under the comments and it has nothing to do with the story printed. I am assuming we are all adults and should be acting like it. I know I am teaching my 5 and 8 yr old this why do we as adults need to carry on the same way?

As for the story...It did mention that there are other agencies involved and from what I recall on the raid there were FBI, Immigration and the DA all involved. It didn't just go to the FBI and no one local looking into it. Housing Authorities looked into it, the local DHHS office and the local police. I hope they give them the maximum time and show others this will not be tolerated. Why should us tax payers have to pay for them to even be in prison??? If you commit a crime and defraud us after we helped you out of your "horrible" country then you are ungrateful and need to be deported. That simple. They have caused enough money to be thrown out the window, any of the Somali community that commit fraud are ungrateful selfish people and return them to their country.

PamD's picture

Well said, I'll even hold the

Well said, I'll even hold the door open for them when they board the bus. The first words they learn is City,State pays us everything.

verified

I agree

After reading all these comments, I have to agree with everything you have said, my sentiments exactly. Not too many comments on the story and alot of bickering back and forth. And as far as the two involved in this crime, I think they should send them back to where they came from. We have dished out enough for their care when alot of deserving people were denied benefits because every bit of monies is used up on so many undeserving. I have know people that have worked all their lives in this country and this state be denied benefits because they made $5.00 over the limit..pretty sad!!! But you can come into this country without ever having contributed a penny, and be handed out all the help they need. Then they turn around and do something like this..or all the gall!!!

conserva-mom's picture

Da Babe

Sultan of swindle? Tron, when speaking of libel, I do believe thinking man may be referring to you calling everyone a racist or a bigot and cleverly insinuating that attend KKK or white supremacist meetings. You've done so to me on occasion and when challenged, your comments cease. It's kind of like ding dong ditch....or punching someone in the back of the head and then running away.

momof4's picture

senor sponge,

Duke of dole, father freebie, ....

lewistonauburnsucks's picture

welfare warrior....handout

welfare warrior....handout hombre.....baron of bailout....seargant slush fund....prince of porkulus, i could probably go on but i'll let someone else come up with a few.

ojhuig's picture

Can we please start banning

Can we please start banning people for the personal attacks???

Pirate's picture
verified

Damn, they're all good.

Damn, they're all good. Really hard to pick one.

tron's picture

Kinda sad when a person spends all his time

thinking up different ways to libel a person. I guess it keeps the simple minds busy.

mbthedragon's picture

That being the case you must

That being the case you must be the busiest living simple minded organism on this planet.

thinkingman's picture

Given some of what you have

Given some of what you have posted in the past, its kinda funny to hear you mention the word "libel"...you wrote the book on that one.....

tron's picture

nice vague accusation,

it makes a weak point without requiring any proof. You hope people will agree, since you have nothing to back it up. Pathetic!!

momof4's picture

or

a couch potato...what does Parrot say?

Pirate's picture
verified

The parrot won't say too many

The parrot won't say too many negative things about Tron. He likes him. It's the liberal thing, ya know? I keep him mainly because he keeps our pet bobcat in line. Scares the crap out of him when he goes into his name calling tirades. Ever see a bobcat try to hide under a bed?

thinkingman's picture

I think tron in spanich is

I think tron in spanich is turd,....

Pirate's picture
verified

Bueno on that one, TMan

Bueno on that one, TMan

Pirate's picture
verified

El Turdo has a nice ring to

El Turdo has a nice ring to it. Good name for a soccer goalie.

lewistonauburnsucks's picture

Tronholio's good, I was

Tronholio's good, I was thinking Tranny

momof4's picture

you can bet

those guys suddenly cannot speak english....deport 'em to Tron's (or would his Cuban name be "Tronholio"?)

preaves's picture

Taking out my mod hat one last time ...

... now play nice. We're all adults here. No need for the name calling.

Pirate's picture
verified

That should go for both

That should go for both sides, but there is little evidence to suggest that it does.

Big Love's picture

No kidding!! Sometimes I

No kidding!! Sometimes I think Keith Olbermann and Rachel Madcow bought the Sun Journal.

Pirate's picture
verified

Even that would be too far to

Even that would be too far to the right for them. Hope that isn't libelous.

Susan2's picture

Coming soon

http://wedg.millenniumweekend.org/forum/showthread.php?t=32145

Short Video of what happened in England recently.

Pirate's picture
verified

Great photo, by the way. Do I

Great photo, by the way. Do I see a little Tom Hanks in there?

tron's picture

One is from Auburn, the other

from Portland, so what country would you be deporting them too? I think we should deport YOU to Cuba, Susan2, that's where you belong.

Pirate's picture
verified

Is there at least a single

Is there at least a single ounce of common sense somewhere that you can embrace? You behave as though you were in a cerebral vacuum. I suspect you're much brighter than that. Most posters think you're an inane unknowing, uneducated nincompoop. How about doing something, for a change, to prove them wrong. (The parrot dictated all of this to me; I just did the typing-and flawlessly, I might add.)
You know darn well, that if Susan were from Cuba, which as you say, is where she belongs, her name would be Senora Suzanno; not Susan 2. Get with it, T....

ojhuig's picture

Was there a point to this

Was there a point to this post, except to make a personal attack? If you disagree, say why and state your point. I don't care what you think of them personally.

preaves's picture

You have the right to

You have the right to disagree with someone, but please be respectful when doing so.

Pirate's picture
verified

But his 13:29 post was

But his 13:29 post was acceptable/

Susan2's picture

Will They Get Any Time?

[This comment has been removed by the administrator]

preaves's picture

I removed this comment

I removed this comment because it violates our commenting policy, particularly because it was:
# Potentially libelous (slanderous)
# Defamatory, abusive, obscene, racist, or otherwise hateful

We don't tolerate hateful language towards any race or religion here.

thinkingman's picture

Paati, I can understand you

Paati, I can understand you removing anything that sounds racist, but calling someone racist is ok?

ojhuig's picture

she didn't call anyone

she didn't call anyone anything. She said they posted something racist that had to be removed.

Pirate's picture
verified

Great post, Susan. Don't you

Great post, Susan. Don't you just love Dick Morris. Hard to believe he once worked for the Clintons.

dlaurels's picture
verified

Prosecute to the fullest

Unfortunately, this happens way too much. I just don't understand why this wouldn't get caught at the beginning of the process. Don't the federal, local and state agencies verify any information?

Pirate's picture
verified

Not when it comes to "you

Not when it comes to "you know who".

Jo's picture

GOOD

Nice going, feds!!! Let's just hope the sentencing judge gives them the maximum, and sends a STRONG message. There's more fraud to be had...prosecute them all to the hilt!

I hope the respective cities are investigating these frauds, as well. Sadly, I doubt it...

The people are sick of lowlife like this who rob from the public. Sock it to 'em!

Pirate's picture
verified

The Immigration Dept. should

The Immigration Dept. should have an interest in this one too.

Advertisement

Stay informed — Get the news delivered for free in your inbox.

I'm interested in ...