PORTLAND — Men from Lewiston and Auburn were charged Tuesday with health care fraud involving the MaineCare program and with soliciting and receiving health care kickbacks over a roughly two-year period, federal prosecutors said.
Abdirashid Ahmed, 38, of Lewiston and Garat Osman, 32, of Auburn, who both worked as interpreters, were indicted by a federal grand jury, according to U.S. District Court records.
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.
From May 2015 to December 2017, Ahmed and Osman conspired to defraud MaineCare by getting kickbacks for referring MaineCare beneficiaries, billing MaineCare for interpreting services not rendered or partially rendered and paying illegal kickbacks with unearned MaineCare money.
Fraudulent bills were submitted to MaineCare that overstated the health and interpreter services provided. MaineCare reimbursed the provider based upon that fraudulent billing, according to the grand jury indictment.
An unnamed MaineCare provider paid Ahmed and other conspirators, including Osman, $200 in kickbacks per referral of MaineCare beneficiaries, according to court records.
A MaineCare provider paid Ahmed a total of $17,500 in kickbacks for referring clients between Aug. 17, 2015 and Jan. 11, 2017, according to court papers. The same provider also paid $6,200 in November 2015 to Global Interpreter Services of Maine, in which Ahmed was a partner, for his referrals.
That MaineCare provider paid Gold Star Interpreting LLC, of which Osman is an owner, $6,200 in January 2017 and $720 in December 2017, in exchange for Ahmed referring patients, according to court papers.
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.
Both were arrested Tuesday morning and made initial appearances in U.S. District Court in Portland on Tuesday. Both pleaded not guilty and were being held in custody until Monday when they will reappear in court for detention hearings.
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 State of Maine Attorney General’s Medicaid Fraud Crime Unit.