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25 snared in $75M Medicaid fraud case

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By The Associated Press
Thursday, Feb. 20, 2014, 9:12 p.m.
 

WASHINGTON — Twenty-five people were charged on Thursday with obtaining at least $75 million in fraudulent Medicaid payments from the District of Columbia government.

Federal prosecutors said the series of cases add up to the largest health care fraud in the city's history.

The alleged schemes, which prosecutors said were similar but not necessarily part of a unified conspiracy, involved bogus claims for home care services — a category of Medicaid claims that has grown dramatically in the city during the past eight years.

The uptick in billings for home care — from $40 million in 2006 to $280 million last year — was part of what tipped off authorities to illegal activity, said U.S. Attorney Ronald Machen.

“We concluded that much of the growth was due to aggressive networks of fraudsters paying kickbacks to beneficiaries to manufacture false claims for nonexistent services,” Machen said. “Medicaid fraud in the District of Columbia is at epidemic levels.”

Prosecutors say many of the defendants persuaded patients to fake illnesses or injuries so that they could bill Medicaid for home care services, which they didn't receive. Some of those patients received kickbacks, authorities said, although no patients have been charged. Those charged include the owners of home care firms and nurse staffing agencies; home care aides; and recruiters who signed up patients.

Florence Bikundi, 51, of Bowie, Md., owner of a home care agency who had lost her nursing license and was barred from participating in Medicaid, billed the city for $75 million in Medicaid payments by using aliases, prosecutors said.

Among her properties seized were millions of dollars from 46 bank accounts, a home valued at $927,000 and five luxury vehicles.

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