DOJ charges 15 in $90m scheme

The U.S. Department of Justice said on May 21 that 15 defendants were charged in Minnesota in a health care fraud takedown tied to more than $90 million in alleged intended losses. Federal officials said the cases involve owners of child care centers and Medicaid providers accused of billing for services that were not provided, using kickbacks and falsified claims across multiple state-run programs. The department said the charges include the two largest Medicaid fraud cases ever brought in the District of Minnesota and first-of-their-kind charges involving additional Medicaid programs. ### Which programs were at the center of the case? Colin McDonald, assistant attorney general for the National Fraud Enforcement Division, said the charges touch seven state-managed Medicaid and related programs that were “systematically pilfered.” CBS Minnesota reported that the cases include Housing Stabilization Services, autism services, Integrated Community Supports and Individualized Home Supports, along with child care-related reimbursements. (justice.gov) The Justice Department said the defendants are accused of participating in “various fraud schemes” that targeted public funds meant for children, seniors, people with disabilities and other vulnerable beneficiaries. In Minneapolis, federal officials said the conduct ranged from false billing to alleged payments to secure patients and beneficiaries. (cbsnews.com) ### Why did officials focus so heavily on autism services? Robert F. Kennedy Jr., the U.S. health secretary, said at the Minneapolis announcement that the arrests marked “the largest autism fraud bust in American history.” Federal officials said one of the major cases involved billing for autism services that were not provided and recruiting children for diagnoses through kickbacks to families. (justice.gov) CBS Minnesota reported that two defendants are accused of paying kickbacks to families who brought children in for autism diagnoses regardless of medical need, then billing the state for treatment that was never delivered. McDonald said Minnesota’s autism program had grown from about $600,000 six years ago to roughly $400 million. ### What did prosecutors say happened to the money? (justice.gov) McDonald said the defendants treated disabled people like “lottery tickets” and spent taxpayer money on luxury cars, real estate and expensive jewelry, according to the Minnesota Reformer. The outlet reported that prosecutors described a pattern in which providers billed public programs and then diverted the proceeds to personal spending. (cbsnews.com) CBS Minnesota reported that one scheme involved a program meant to help people with disabilities live independently. McDonald said a man who was supposed to receive around-the-clock care was not served and died, while providers allegedly continued to draw funds. ### Who announced the takedown in Minneapolis? Daniel Rosen, the U.S. attorney for Minnesota, appeared at the federal courthouse in downtown Minneapolis with Kennedy, Centers for Medicare and Medicaid Services Administrator Dr. (minnesotareformer.com) Mehmet Oz and FBI officials, the Minnesota Reformer reported. Acting Attorney General Todd Blanche was expected but remained in Washington, according to the same report. (cbsnews.com) Todd Blanche said in the Justice Department release that the defendants “ripped off the American taxpayer and harmed those deserving legitimate assistance from these programs.” FBI Director Kash Patel said the defendants are alleged to have stolen public health care funds and resources from families who needed them. (minnesotareformer.com) ### What happens next in the federal response? The Justice Department said the Minnesota cases were announced alongside an expansion of its Health Care Fraud Section, with funding for 15 new trial attorney positions focused on Medicaid fraud nationwide. McDonald said the added prosecutors would support existing strike forces and expand the federal response to Medicaid fraud. (justice.gov) The District of Minnesota will now handle arrests, initial appearances and the next round of court proceedings for the charged defendants. Federal officials said on May 21 that law enforcement was still working to bring some suspects into custody, including Muhammad Omar, whom local television footage showed fleeing during an arrest attempt. (cbsnews.com) (justice.gov)