Federal prosecutors charged three people in October in separate schemes that allegedly defrauded Minnesota’s Medicaid autism therapy program of about $35 million combined.
The cases target the Early Intensive Developmental and Behavioral Intervention program, which covers intensive therapy for Medicaid enrollees younger than 21 who have autism spectrum disorder or related conditions.
They are part of a broader enforcement surge in which the Justice Department and the U.S. Attorney’s Office for the District of Minnesota charged, convicted or sentenced 13 defendants between Sept. 30 and Oct. 30. Those cases involved nearly $83 million in intended losses across Medicaid, the Supplemental Nutrition Assistance Program and federal child nutrition programs. Prosecutors have issued more than 1,000 subpoenas in Minnesota this year.
The largest case involves Habiba Mohamed, 58, of Coon Rapids, Minn., who was charged Oct. 29 with conspiracy to defraud the U.S. in a $19.1 million scheme targeting the autism program. Ms. Mohamed allegedly paid kickbacks to parents of Medicaid recipients in the program in exchange for the ability to bill for services. Her co-conspirators in the scheme were previously charged.
Feisal Mohamed Elmi, 46, of New Brighton, Minn., was charged Oct. 22 with 11 counts of healthcare fraud tied to an $8.2 million scheme to defraud the autism program. Mr. Elmi allegedly billed for autism therapy services that were never provided, including services claimed while employees were outside the U.S. He also allegedly billed nearly every claim at the same amount, no matter the service or the hours involved.
Emily Marice Ravits, 74, of Tucson, Ariz., a licensed clinical social worker, was charged Oct. 22 with conspiracy to defraud the U.S. and to make false statements related to healthcare matters, plus six counts of making false statements related to healthcare matters. Prosecutors allege Ms. Ravits served as a qualified supervising professional in Minnesota for several autism providers without performing the required duties. Her role allegedly enabled $7.7 million in false claims, including false certifications on treatment plans.
The cases follow a May takedown in which the Health Care Fraud Strike Force of the Justice Department’s National Fraud Enforcement Division charged 15 defendants in what the department called the largest Medicaid fraud takedown in state history.
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