Two men were sentenced on Friday for their roles in a multi-million-dollar MaineCare fraud conspiracy that included getting people from the Somali community to fake mental illnesses.
Abdirashid Ahmed, 41, of Lewiston was sentenced to two years in prison to be followed by three years of supervised release, according to the U.S. Attorney’s office. In addition, Ahmed was ordered to pay more than $1.8 million in restitution to MaineCare.
Garat Osman, 35, of Auburn was sentenced to three years of probation, and ordered to pay $544,000 in restitution.
The pair ran the scheme from November 2015 until May 2018 by submitting claims to MaineCare for services that were not rendered as billed, and received around $200 for each claim, according to the 2018 indictment.
Ahmen and Osman had been owners or part owners of translator services, before conspiring with Nancy Ludwig, 65, of Lewiston, owner of Facing Change, a mental health and substance abuse counseling agency, to defraud the health care system, according to court documents. Throughout the scheme, Ludwig and the two men filed fraudulent claims through MaineCare for counseling and interpreter services.
MaineCare received claims for 59 Somali beneficiaries as part of this fraud, according to the U.S. Attorney’s office. Ahmed and Oman recruited people from the immigrant community to pretend to be suffering from mental illness.
Ahmed and Osman received kickbacks from Ludwig in exchange for referring beneficiaries to her, according to court documents. Then, Ahmed and Osman brought people who received MaineCare to the provider and served as Somali interpreters during the visits.
At the time of the fraud, MaineCare paid interpreters $20 per 15 minutes of interpreting, according to the indictment. Both men admitted to overbilling for more than an hour of interpreting per visit when the visits did not last that long.
Ludwig was sentenced to 3 1/2 years in prison in February 2020 after a jury found her guilty for her role in the scheme. She also was sentenced to three years of supervised release and ordered to pay nearly $661,000 in restitution to MaineCare.
The two men initially pleaded not guilty in 2018, but changed their pleas in May 2019. The coronavirus pandemic delayed their sentencings, which took place in person with court-appointed interpreters.
The conspirators each faced up to 10 years in prison and fines of up to $250,000.