Eighteen people charged by Minnesota attorney general in Medicaid caregiver fraud case

A Twin Cities agency bilked Minnesota's Medical Assistance program out of $9.5 million by billing for home care that it didn't provide or that lacked required nursing supervision, according to a state complaint.

Minnesota Attorney General Keith Ellison announced racketeering and other charges against the owners and managers of MN Professional, a now-closed personal care assistance (PCA) agency. The case is the largest uncovered by the state's Medicaid Fraud Control Unit, resulting in charges against 18 people when also including recruiters, an office manager and PCAs employed by the agency.

Minnesotans should expect to receive dignified care when they need it and to have their tax dollars spent legally, Ellison said in a statement Tuesday afternoon. "People who commit Medicaid fraud violate both of those rights."

Most of the alleged fraud from 2016 through 2021 involved care provided to 120 people in the absence of supervision by nurses or other qualified medical professionals. But an investigation also uncovered claims for about 25,000 hours of care that were never provided. When investigators showed caregivers pictures of their supposed clients, they couldn't recognize them or identify their names.

Charges against the owners — Abdikarim Mohamed and Ahmed Nur — are the latest step in a joint investigation that involved the inspector general of the U.S. Department of Health and Human Services and the Minnesota Commerce Fraud Bureau. Five of the 18 people charged in the case have pleaded guilty.

The Star Tribune was not able to reach Mohamed or Nur for comment Wednesday.

The state complaint alleged an "elaborate" check-cashing scheme to try to conceal the fraudulent billing. Agency officials allegedly wrote checks in the names of PCAs — artificially inflating workers' taxable wages — but then cashed them for themselves.

The owners also allegedly listed their wives as board members and consultants and paid them hundreds of thousands of dollars, and are accused of falsifying information to obtain COVID-19 relief loans.

The owners allegedly received a COVID-related paycheck protection loan, even though workers told investigators that they weren't paid for sick time and were encouraged to submit more hours once they were healthy so the agency could maintain its billing levels.

The agency also received a federal employee retention credit that was only intended for companies that were forced to suspend operations or lost more than 50% of their revenue as a result of the pandemic. The only quarter when the company lost that much was in late 2021, when the state stopped paying the agency because of credible evidence of fraud.

The attorney general's Medicaid fraud unit has pursued four prior cases involving $2 million or more in fraudulent claims, including a $7.7 million case that resulted in two convictions in 2019.