State’s ‘PITSTOP-66’ investigation uncovers widespread Medicaid fraud

At least 19 people have been charged or convicted thus far and more charges are expected.

Medicaid
Two of those charged are accused of having “operated a non-emergency medical transportation company, Driving Miss Daisy, that bilked the Medicaid program." (Driving Miss Daisy/Facebook)

Last month, the Minnesota Attorney General’s Office (AGO) announced a pair of new indictments connected to the ongoing PITSTOP-66 investigation. Charles Omato and LaTonia Jackson are facing criminal charges after allegedly defrauding Medicaid of roughly $1.4 million.

Omato and Jackson are accused of having “operated a non-emergency medical transportation company, Driving Miss Daisy, that bilked the Medicaid program in two ways: by billing for transportation services that were not provided at all, and by billing for transportation services that could not have occurred as alleged, including billing for services that were based on impossible travel times documented by drivers.”

These two individuals were charged in connection with the “PITSTOP-66” investigation, a joint venture involving the AGO’s Medicaid Fraud Control Unit, the Minnesota Commerce Fraud Bureau, and the Department of Health and Human Services’ Office of the Inspector General.

According to court documents explaining the details of the PITSTOP-66 investigation, the “PIT” in PITSTOP stands for Provider, Interpreter, and Transportation. Additionally, the number 66 is the county code for Rice County, where much of the fraud originated. As such, the PITSTOP-66 investigation is focused on uncovering individuals who are fraudulently billing Medicaid for transportation, interpreter, and other services.

In May, eight people were criminally charged by the AGO after they allegedly used stolen identities “to bill the Medicaid program for services that the victims did not receive and that the co-conspirators did not provide.” Those services reportedly included transportation, interpreter, and specialty-clinic services.

A woman named Nasro Aden Takhal was allegedly at the center of this scheme. The AGO said Takhal’s co-conspirators included Fardosa Ali Ibrahim, Bashir Aden Bare, Warfa Osman Mohomud, Omar Abdi Ahmed, Amal Mohamed Budul, Khalif Abdi Madobe, and Bishara Salat Abdirahman.

The group’s scheme allegedly defrauded Medicaid of $2.6 million.

“Collectively, the co-conspirators are charged with 67 felonies, including racketeering, felony theft, and identity theft,” said the AGO in a press release regarding the eight indicted individuals.

In the same press statement, the AGO said that so far “9 people have been convicted as a result of the PITSTOP 66 enforcement effort, including chiropractors, mental health therapists, interpreters, and transportation drivers. Others are presently facing charges. Additional charges are expected against other individuals, including owners and employees of other Medicaid-funded clinics and health care companies, as the investigation continues.”

When adding the AGO’s statement with the May and June indictments, the PITSTOP-66 investigation has led to charges being brought against at least 19 individuals so far.

“The PITSTOP-66 investigation has spanned several years, involved the review and analysis of hundreds of thousands of pages of documentation and digital evidence, the execution of numerous search warrants, and well over one hundred interviews with participants and victims of the scheme,” reads a summation of the operation.

However, the multi-year PITSTOP-66 investigation is not the only operation that has led to significant Medicaid fraud charges this year.

In June, the AGO criminally charged two people for their roles in an alleged scheme which reportedly defrauded Medicaid of roughly $7.2 million. According to the AGO, Abdifatah Yusuf and Lul Ahmed “bilked the program through their agency, Promise Health Services.”

This investigation was not a part of the PITSTOP-66 operation.

“Promise claimed to provide home and community-based (waivered) services, but it lacked any office building and operated for years out of a mailbox. The co-conspirators fraudulently obtained Medicaid funds by billing for services not provided, services that were billed based on false documentation, services that were overbilled, services that were billed but lacked any documentation to support the services, and kickbacks provided to recipients to induce them to receive ‘services’ from the agency,” said the AGO.

The $7.2 million allegedly stolen was used “to fund a lavish lifestyle,” with the pair having reportedly spent “more than $22,000 at furniture stores despite Promise lacking any physical office space, spent over $42,000 at luxury automotive dealers, and over $80,000 at luxury clothing stores including Coach, Canada Goose, Michael Kors, Third Degree Heat, Nike, and Nordstrom.”

Abdiweli Mohamud, another individual accused of Medicaid fraud, faces six counts of felony aiding and abetting theft by swindle, and one racketeering charge. Mohamud’s case is not connected to PITSTOP-66.

An AGO press report described Mohamud as the owner of “Minnesota Home Health Care LLC, but he allowed Abdirashid Said, a federally excluded provider, to control the company.” Abdirashid Said was previously charged by Ellison, along with two others, for “a scheme to defraud the Minnesota Medical Assistance (Medicaid) program out of nearly $11 million.”

Evan Poellinger contributed to this report. 

 

Luke Sprinkel

Luke Sprinkel previously worked as a Legislative Assistant at the Minnesota House of Representatives. He grew up as a Missionary Kid (MK) living in England, Thailand, Tanzania, and the Middle East. Luke graduated from Regent University in 2018.