Ten Minnesotans were charged as part of a national health care fraud takedown, Minnesota Attorney General Lori Swanson announced in a news conference Thursday morning.
The “largest health care fraud takedown operation in American history,” according to Attorney General Jeff Sessions, involved more than 400 licensed health professionals nationwide and totaled $1.3 billion in false billing.
Two separate rings of Minnesotans were charged for a combined $8.6 million swindled, according to Swanson.
“It’s an affront to the taxpayers who finance these programs with their generosity when criminals steal money from the programs and bilk the systems,” Swanson said.
She said the aim of the takedown is to deter people from abusing the system, to encourage people to report fraud, and to penalize those involved.
The investigation required 40 search warrants and 1 million separate files, Swanson said, but it all started with one person’s tip to the Department of Human Services.
Swanson filed a criminal complaint against a mother-daughter duo
Thursday for bilking $900,000, and a group earlier this week for $7.7 million.
Juanita Swain, 54, of Brooklyn Center, and her daughter Aretina Williams, 34, of Brooklyn Park, used Your Way Home Care, Inc., a health care agency they co-owned, to fraudulently bill Medical Assistance for about $929,000, Swanson said.
The duo billed Medical Assistance by submitting bills for services that were not provided, usurping people’s identities to submit false claims, and paying unlawful kickbacks to recipients who threatened to blow the whistle, she said. Some of the services supposedly delivered were to a man who was in prison, according to criminal complaints filed in Hennepin County District Court.
In one instance, Your Way billed more than $200,000 for personal care attendant services that were not provided for a mother and her three children, Swanson said. Williams paid kickbacks to the mother to induce her to cooperate with the scheme, telling her “Christmas came early” in one text message about the kickbacks.
When Your Way Home Health Care’s authority to file claims was suspended by the Minnesota Department of Human Services, Williams’ father, 57-year-old Michael Carson of Park Forest, Ill., acted as a “front,” allowing Williams to open a new home health care, Swanson said.
Charged in the alleged operation were:
Earlier this week, Swanson charged Lillian Richardson (Swain’s cousin), 53, and six accomplices for defrauding the Medical Assistance program through five different agencies. Richardson was working remotely from Arkansas after she had previously been banned from working with Minnesota agencies after being convicted of medical costs theft in 2012.
Similar to the Williams-Swain cases, Richardson’s also charged Medical Assistance for services not provided, using the identity of unknowing people, and signing time sheets without completing work, among other complaints, Swanson said.
Richardson instructed her accomplices to keep the matter private, telling one of them in a text message to “get a little phone today that we can text each other” on, and “don’t talk about dhs business on your phone,” according to Swanson.
Facing a charge of racketeering and eight charges of aiding and abetting theft by swindle in the alleged operation were:
“Health care fraud against public programs is not a victimless crime,” Swanson said. “The victims are every single taxpayer who helps fund this program and take care of taxpayer needs.”
She said there are most likely several other fraud schemes in Minnesota and nationally, and her department submitted many recommendations to the Department of Human Services to prevent fraud rather than catching it at the end.
The national investigation also exposed more than 120 doctors for illegally prescribing and distributing dangerous narcotics, a statement by the U.S. Attorney General’s office said Thursday.
“Last year, an estimated 59,000 Americans died from a drug overdose, many linked to the misuse of prescription drugs. This is, quite simply, an epidemic,” Acting Administrator of the Drug Enforcement Administration Chuck Rosenberg said in a statement. “There is a great responsibility that goes along with handling controlled prescription drugs, and DEA and its partners remain absolutely committed to fighting the opioid epidemic using all the tools at our disposal.”
Almost 300 health care providers have been suspended or banned from participating in federal health care programs, according to Sessions.