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.

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Comments

Dave Bussey's picture

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!

 's picture

I was unaware that

Auburn and Portland are now part of Somalia.

PAUL ST JEAN's picture

Hey, what about Loiston?,

Hey, what about Loiston?, said the parrot.

Shannon White's picture

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.

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!!!

PAUL ST JEAN's picture

Damn, they're all good.

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

 '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.

 's picture

That being the case you must

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

 '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!!

PAUL ST JEAN's picture

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?

PAUL ST JEAN's picture

Bueno on that one, TMan

Bueno on that one, TMan

PAUL ST JEAN's picture

El Turdo has a nice ring to

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

PAUL ST JEAN's picture

That should go for both

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

PAUL ST JEAN's picture

Even that would be too far to

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

PAUL ST JEAN's picture

Great photo, by the way. Do I

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

 '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.

PAUL ST JEAN's picture

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....

PAUL ST JEAN's picture

But his 13:29 post was

But his 13:29 post was acceptable/

PAUL ST JEAN's picture

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.

Doreen Sheive's picture

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?

PAUL ST JEAN's picture

Not when it comes to "you

Not when it comes to "you know who".

PAUL ST JEAN's picture

The Immigration Dept. should

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

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