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At least $9B billed across 14 Medicaid services in Minnesota may be fraudulent, top prosecutor says

  

Category:  News & Politics

Via:  s  •  11 months ago  •  12 comments

At least $9B billed across 14 Medicaid services in Minnesota may be fraudulent, top prosecutor says

S E E D E D   C O N T E N T


A top prosecutor suggested on Thursday that the total amount of fraud in Minnesota could be $9 billion or more.

According to First Assistant U.S. Attorney Joe Thompson, 14 Medicaid services   under audit and deemed "high risk" for fraud   have cost the state $18 billion since 2018.

Thompson said a substantial amount of money billed across those programs is fraudulent, but the exact amount is still under investigation. 

"I don't make these generalizations in a hasty way," he said. "When I say significant amount, I'm talking on the order of half or more. But we'll see. When I look at the claims data and the providers, I see more red flags than I see legitimate providers."

Minnesota Department of Human Services Inspector General James Clark released a statement, saying speculation of the amount of fraud occurring is "shocking."

"If there is evidence of Medicaid fraud, the state should be given the information so DHS can slam the door shut on payments to those individuals and businesses," Clark said. "We have been moving more aggressively than ever to suspend payments where we see evidence of fraud and refer criminals to law enforcement for prosecution. I've previously sent letters to the U.S. Attorney's Office asking them to share evidence of fraud and I'm requesting a meeting immediately to discuss how we can partner to stop criminals now."

Thompson said the scale of fraud in Minnesota outpaces that of other states and puts services at risk for people who really need them.

While prosecutors typically see fraud manifest as providers overbilling, Thompson said during a news conference in Minneapolis that companies have been created to provide zero services while pocketing federal funds for international travel, luxury vehicles and lavish lifestyles.

"The magnitude cannot be overstated," Thompson said. "What we see in Minnesota is not a handful of bad actors committing crimes. It's staggering, industrial-scale fraud."

The investigators' new findings may bolster President Trump in his claims that Minnesota is a "hub of fraudulent money laundering activity" under Gov. Tim Walz, who was the Democrats' vice presidential nominee in last year's presidential election.

Trump has capitalized on the fraud cases to target the Somali diaspora in Minnesota, calling them "garbage" and saying he doesn't want immigrants from the East African country in the U.S.

More than 90% of the people charged in the major fraud cases announced before today were of Somali descent, according to the U.S. Attorney's Office for Minnesota.

Walz has denounced Trump's comments, saying an audit due for completion by late January should give a better picture on the extent of the fraud. He said his administration is taking aggressive action to prevent fraud in the future. A spokesperson for Walz did not immediately respond to an email seeking comment Thursday.

Five new defendants have been charged in connection with a Minnesota housing services fraud, Thompson said. Two of them pocketed $750,000 instead of helping Medicaid recipients find stable housing, he said. Prosecutors allege they used the proceeds to travel to international destinations, including London, Istanbul and Dubai.

One defendant submitted $1.4 million in fraudulent claims, using some of the funds to purchase cryptocurrency, Thompson said. Federal officials say he fled the country after receiving a subpoena.

The five charged   include two Philadelphia residents who have been accused of "fraud tourism"   after they registered as Minnesota providers, Thompson said, adding that for them the scheme was "easy money."

"Minnesota has become a magnet for fraud, so much so that we have developed a fraud tourism industry – people coming to our state purely to exploit and defraud its programs," Thompson said. "This is a deeply unsettling reality that all Minnesotans should understand."

The two men, Anthony Waddel Jefferson and Lester Brown, were accused of siphoning millions from federally funded programs administered by Minnesota officials that were meant to help the disabled and those suffering from addiction, according to court filings.

They allegedly fleeced the housing program in Minnesota despite "living on the other side of the country and having no network in or connections to Minnesota or its communities," the filings stated.

They join eight others charged in September for their alleged roles in the scheme to defraud the  Minnesota Housing Stability Services Program .

Prosecutors also named a new defendant accused of defrauding another state-run, federally funded program that provides services for children with autism, alleging he submitted millions of dollars worth of claims for Medicaid reimbursement. One woman previously charged for exploiting that program pleaded guilty Thursday morning, officials said.

Asked who is to blame, Thompson said the state "has not done a good job of mining these programs."


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Sean Treacy
Professor Principal
1  seeder  Sean Treacy    11 months ago

It's just Minnesota, right?

 
 
 
Vic Eldred
Professor Principal
1.1  Vic Eldred  replied to  Sean Treacy @1    11 months ago
 
 
 
Snuffy
Professor Participates
2  Snuffy    11 months ago

You gotta love how some Democrats are blaming this on Trump for firing the Inspector Generals all while ignoring that this started back in 2020 as this was funded by Covid money. 

"There's always a fraud issue. That's why the Department of Justice had a huge civil fraud division that did a lot of great work, and that's why we have [Inspector Generals] and the like throughout the federal government. The elimination of those, firing that cadre of people was one of the worst things the Trump administration could do if they're serious about fighting waste, fraud, and abuse," said Rep. Glenn Ivey, D-Md.

Some Dems signal Walz should testify over fraud scandal, others duck responsibility | Fox News

 
 
 
bugsy
Professor Participates
2.1  bugsy  replied to  Snuffy @2    11 months ago

Probably started before 2020. Just became easier during the COVID years to steal American money.

 
 
 
Ozzwald
Professor Quiet
3  Ozzwald    11 months ago

Good thing republicans have control of the government then.  They are experts in Medicare/Medicaid fraud.

From Google AI:

Rick Scott was the CEO of the hospital chain Columbia/HCA during the time of the largest health care fraud settlement in U.S. history at the time, which resulted in the company paying the federal government $1.7 billion in fines. Scott was forced to resign in 1997 amidst the federal investigation but was never personally charged with any crimes.
Details of the Case
  • Company Role: Scott co-founded Columbia Hospital Corporation in 1987, which later merged with HCA (Hospital Corporation of America). He served as the CEO of the combined company, Columbia/HCA, which grew to be the largest hospital chain in the U.S..
  • The Fraud: The company engaged in widespread, systemic fraud against federal healthcare programs, including Medicare, Medicaid, and Tricare. Specific actions included:
    • Filing false Medicare and Medicaid reimbursement claims.
    • Billing the government for unnecessary tests and services not ordered by physicians.
    • Inflating patient diagnoses to increase reimbursements.
    • Offering illegal kickbacks, such as bogus consulting jobs, free rent, and free trips, to doctors in exchange for patient referrals.
  • The Investigation and Settlement: The federal investigation by the FBI, IRS, and Department of Health and Human Services went public in March 1997 with raids on Columbia/HCA facilities. Scott resigned as CEO a few months later. The company ultimately pleaded guilty to 14 corporate felonies and agreed to a series of settlements with the Department of Justice in 2000 and 2003, totaling $1.7 billion.
  • Scott's Involvement: Scott maintained he was unaware of any wrongdoing and attributed the investigation to political motivations by the Clinton administration. He was never charged individually with a crime. However, during a civil lawsuit deposition unrelated to the fraud investigation in 2000, he invoked his Fifth Amendment right against self-incrimination 75 times. He left the company with a substantial severance package and stock options. 

 
 
 
bugsy
Professor Participates
3.1  bugsy  replied to  Ozzwald @3    11 months ago
He was never charged individually with a crime

 
 
 
Sean Treacy
Professor Principal
3.1.1  seeder  Sean Treacy  replied to  bugsy @3.1    11 months ago

He was never charged individually with a crime

It also happened almost thirty years ago…

 
 
 
Ozzwald
Professor Quiet
3.1.2  Ozzwald  replied to  Sean Treacy @3.1.1    11 months ago
It also happened almost thirty years ago…

So that makes it okay in your mind?

 
 
 
Sean Treacy
Professor Principal
3.2  seeder  Sean Treacy  replied to  Ozzwald @3    11 months ago

lol. so desperate to deflect

 
 
 
Right Down the Center
Professor Participates
3.3  Right Down the Center  replied to  Ozzwald @3    11 months ago

Care to comment on the article?

 
 
 
Sean Treacy
Professor Principal
4  seeder  Sean Treacy    11 months ago

“Something is profoundly wrong with the U.S. welfare system—a problem that runs far deeper and is more dangerous than the shocking fraud in Minnesota that has been making headlines… real federal welfare spending has soared by 765%, more than twice as fast as total federal spending, and now costs $1.4 trillion annually. Were that money simply doled out evenly to the 19.8 million families the government defines as poor, each household would receive more than $70,000 a year.”

It's fraud all the way down.

 
 
 
Vic Eldred
Professor Principal
5  Vic Eldred    11 months ago

This fraud case in Minnesota and another recent one in Maine touches on the issue of refugees and political power as well.

I happen to run across this podcast which connects all three:

 
 

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