PORTLAND — Two Twin Cities men and a Winthrop woman accused in federal court of health care welfare fraud denied related charges this week.

At hearings Wednesday and Thursday in U.S. District Court, Garat Osman, 32, and Abdirashid Ahmed, 38, of Lewiston entered not guilty pleas to felony charges, including conspiracy to commit health care fraud, conspiracy to defraud the United States and receiving health care kickbacks. The first charge is punishable by up to 10 years in prison; each of the other charges is punishable by up to five years in prison.

Ahmed was indicted on three counts of the first charge, two counts of the second and 12 counts of the third. He also was charged with health care fraud, which is punishable by up to 10 years in prison.

Osman was indicted on one count of the first charge, one count of the second and two counts of the third.

Both were released from custody and outfitted with an electronic monitoring device equipped with a built-in GPS unit to track his movements. Pending trial, they are not allowed to leave Androscoggin County without permission from his supervisors at the U.S. Pretrial and Probation Office, according to court papers.

Osman and Ahmed were freed on personal recognizance and each has signed a $5,000 bond to ensure they will appear in court for future hearings.

Ahmed surrendered his passport; Osman may not apply for a passport. Neither man may have any contact with any witnesses or victims involved in the investigation.

Both men were charged in May by a grand jury that handed up an eight-count indictment. This month, that indictment was negated when a 27-count indictment containing additional charges was handed up.

Also named in the new indictment is Nancy Ludwig, 65, of Winthrop, owner of Facing Change, a MaineCare — Maine’s Medicaid program — provider in Lewiston that offered mental health and substance abuse counseling.

She is charged with one count of conspiracy to commit health care fraud, one count of conspiracy to defraud the United States, five counts of paying health care kickbacks, one count of making a false statement relating to a health care matter and one count of obstruction of a federal audit. The first count is punishable by up to 10 years in prison, each of the others is punishable by a maximum of five years in prison.

On Thursday, she denied the nine charges. She was released on personal recognizance and surrendered her passport.

The new indictment claims Ahmed and Osman, who offered interpreting services through various companies, engaged in health care fraud involving MaineCare and received health care kickbacks. Both men are accused of referring MaineCare beneficiaries to one or more unnamed (in the indictment) health care providers and served as Somali interpreters, according to investigators.

The indictment says Ahmed referred MaineCare beneficiaries to providers who billed Medicaid for interpreting services that weren’t provided or overbilled Medicaid for interpreting services starting in 2014.

The indictment also said from May 2015 to December 2017, Ahmed and Osman conspired to defraud MaineCare by billing the program for interpreting services not rendered or partially rendered.

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 indictment.

The indictment says Ahmed and Osman brought MaineCare beneficiaries to Facing Change “purportedly for treatment” where the two men would serve as interpreters during those visits. “Members of the conspiracy would generate documentation that was kept in a patient’s file that would make it look like the health treatment and interpretation services lasted a certain duration when in fact the visit had not occurred or lasted a shorter duration,” according to the indictment.

When Facing Change received reimbursement from MaineCare for those services, Facing Change paid Ahmed, Osman and their companies for the interpreting services they hadn’t performed or had underperformed, the indictment said. The interpreter invoices were “altered to remove the 10 percent remuneration that Facing Change was paying” Ahmed, according to the indictment.

After MaineCare changed its eligibility requirements for reimbursement for interpreting services, Ludwig diagnosed existing patients that Ahmed had referred to Facing Change with a new diagnosis so that those patients would remain eligible for interpreting services, according to the indictment.

Osman and Ahmed received kickbacks for their referrals to MaineCare providers, the indictment said.

cwilliams@sunjournal.com

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