Minnesota AG Ellison brings charges in Faribault area Medicaid fraud scheme [Star Tribune]

Star Tribune (Minneapolis, MN)

Minnesota Attorney General Keith Ellison is charging eight people in connection with an alleged scheme to defraud the state's Medicaid program out of nearly $2.6 million.

In charges filed Friday in Rice County District Court, Ellison alleged that co-conspirators used the stolen identities of hundreds of people, largely in the Faribault area, to bill Medicaid for services the victims did not receive and the co-conspirators did not provide.

They are charged with 67 felonies, including racketeering, felony theft and identity theft, according to a news release issued by Ellison's office. The charges come about five months after Ellison brought charges in another Medicaid fraud case, which involved about $11 million in billing.

In the latest case, "the co-conspirators' conduct primarily involves fraudulently billing the Medicaid program for transportation, interpreter, and specialty-clinic services, including acupuncture, physical therapy, chiropractor, and mental-health services, that were not provided at all, or were not eligible for reimbursement from the Medicaid program," the office said in a news release.

Medicaid is a state-federal health insurance program that primarily serves lower-income residents. The program in Minnesota is called Medical Assistance, which often provides benefits through private managed care companies such as Minneapolis based-UCare.

In the scheme, defendants used patient identities, Ellison says, to bill for Medicaid-funded services throughout the Twin Cities, often between 50 and 60 miles from the Faribault area even though service providers were available much closer to home. UCare permits members to travel up to, but not over, 60 miles for a medical service without pre-authorization, according to the attorney general.

Ellison alleges the co-conspirators often steered victims towards clinics that lay just under the 60-mile limit, enabling transportation drivers who were part of the scheme to maximize their reimbursement.

"A criminal complaint is merely an allegation," the news release states, "and the defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law."

According to the news release: Nasro Aden Takhal, the principal actor, is charged with one count of racketeering, six counts of identity theft, and ten counts of aiding and abetting felony theft. Takhal did not immediately respond to a request for comment.

Three co-conspirators were charged with racketeering, identity theft and aiding and abetting felony theft, according to the news release. Four other co-conspirators are charged with identity theft and aiding and abetting felony theft.