A home health aide could serve years in prison after billing Medicaid for thousands of hours he never worked — causing the program to lose more than $730,000, federal prosecutors say.
This includes 3,400 hours he spent traveling internationally instead of caring for residents in Washington, D.C., which he claimed he was doing on his submitted time sheets, court documents show. As a result, Medicaid was billed $70,100 for services the man never provided as he took trips to Europe and Africa.
The health aide, of Lanham, Maryland, pleaded guilty to health care fraud on Monday, Nov. 28, after scamming the D.C. Medicaid program out of $733,405, which he has now agreed to pay back, the U.S. Attorney’s Office for the District of Columbia announced in a news release.
After billing Medicaid for hours he never worked, he was directly paid $396,155 between 2015 and 2021, according to court documents. He submitted false time sheets claiming to help 17 D.C. residents with their personal care, including getting dressed, bathing, eating and more, prosecutors say.
The man will also pay back the $396,155, which was earned illegally, in a forfeiture money judgment, according to prosecutors. This comes after he admitted the money is gone, court documents state.
An attorney representing the man declined a request for comment from McClatchy News..
He will likely be sentenced to more than two years in federal prison, according to the release.
While the man was employed as a personal care aide and a participant-directed worker, he didn’t work as much as he said he did, according to prosecutors.
One individual he previously cared for told investigators the man used to arrive at his home on weekends for eight hours a day, prosecutors say. However, “at one point, (he) disappeared” and never showed up again, the complaint states.
Another resident he cared for told law enforcement that the man was his home health aide for one year and wouldn’t work on Christmas holidays, according to the complaint.
But Medicaid claims data showed the man purportedly provided care services to the individual “almost every day between November 2015 and September 2019, including on Christmas Day in 2015, 2016, 2017, and 2018,” the complaint states.
In addition to getting caught recording his time traveling as work hours, the man billed Medicaid for 24 hours of work he claimed to do in a single day — 156 separate times, according to the release.
For hundreds of other days, the man submitted time sheets saying he worked more than 16 hours in a day while caring for at least two Medicaid beneficiaries, according to the complaint. But these time sheets had overlapping hours.
Since 2018, 12 former health aides have pleaded guilty to defrauding Medicaid, including the man, the release says.
In the U.S., about 82 million people are covered by the program.
Prosecutors ask those who may know about someone engaging in health care fraud to contact the Department of Health and Human Services’ Office of Inspector General hotline at 800-HHS‑TIPS (800-447-8477) or the D.C. Office of the Inspector General at 800-724-TIPS (800-274-8477).
Lanham, where the man is from, is about 15 miles northeast of Washington, D.C.