Two convicted of Medicaid fraud

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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.

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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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