Lewiston Men Sentenced to Million Dollar Health Care Scam | USAO-ME

PORTLAND, Maine Two Lewiston men were sentenced today in US District Court in Portland for health care fraud, Acting US Attorney Donald E. Clark announced.

US District Judge Jon D. Levy sentenced Abdirashid Ahmad, 41, two years in prison and three years of supervised release, and Garat Osman, 35, up to three years of probation. Judge Levy also ordered Ahmed to pay $1,863,264.83 and Osman to pay $544,097.78 in damages to MaineCare. Both pleaded guilty in May 2019.

According to court records, Ahmed and Osman were translators who conspired with several Lewiston/Auburn mental health counseling services to defraud MaineCare. One of the counselors is Nancy Ludwig, owner of Facing Change, a mental health and substance abuse counseling agency in Lewiston. From approximately November 2015 to May 2018, Ludwig and Ahmed led a conspiracy to commit health care fraud by filing a claim with MaineCare for services not provided as billed.

Starting February 2015, Ludwig agreed to repay Ahmed in return for Ahmed bringing MaineCare beneficiaries to Face Change. Ludwig, Ahmed, and other employees at Facing Change then led to false and fraudulent claims being filed with MaineCare for counseling and interpreting services. False claims include claims for visits that never occurred and claims that increase the level of service provided. In 2016, in response to a change in MaineCare regulations, Ludwig and Ahmed conspired to change the diagnosis of many of Ahmed’s clients to schizophrenia so that they could remain eligible to receive MaineCare reimbursement for services on Facing Change.

In the fall of 2016, auditors with the MaineCare Program Integrity Unit audit Faced Change. Ludwig and many of his employees conspired to create false and fraudulent records in an attempt to deceive auditors. Osman joined the fraud scheme in December 2016 and founded an interpreter firm that accepted all fraudulent payments from then to early May 2019. In May 2019, agents with the US Department of Health and Human Services, Office of the Inspector General (HHS-IOG), FBI and the Maine Attorney General’s Office executed search warrants at Facing Change and Ahmeds businesses. Investigators eventually determined that MaineCare had been swindled for $1,863,264.83 in this fraudulent scheme.

Healthcare scams drain funds intended to provide care for our nation’s most vulnerable, said Phillip M. Coyne, Special Agent Responsible for HHS-OIG. Today’s sentencing is a powerful reminder that we will spare no resources to prosecute those who undermine the integrity of our federal health care system and those served by it. I appreciate the ongoing partnership with the US Maine Attorney’s Office to protect public funds.

Federal and state investigators did an extraordinary job of uncovering this fraudulent scheme, said Acting US Attorney Clark. The US Attorney’s Office is proud to be part of the team that brought these defendants to justice. We will always aggressively pursue those who try to deceive the public in this way.

People who suspect health care fraud are encouraged to report them by calling 1-800-HHS-TIPS.

The prosecution is the result of a three-year collaborative investigation by HHS-OIG, the FBI and the Maine Attorney General’s Health Crimes Unit. The investigation was initiated due to audit work carried out by the MaineCare Program Integrity Unit.