Three People Arraigned in Connection with Stealing Over $120,000 From State Medicaid Program
Maryann Mohamoud, age 43, of New Salem, was arraigned yesterday on charges of Medicaid False Claims (4 counts), and Larceny by False Pretenses. Mohamoud entered a plea of not guilty before Clerk Magistrate Connie S. Wong. Mohamoud was released on personal recognizance and ordered not to leave the state without permission from the Attorney General's Office. She was also ordered not to have any contact with any of the witnesses involved in the case.
Africa Mohamud, age 34, of Boston, and Oscar Savaria, age 27, of Granby, were also arraigned yesterday on charges of Medicaid False Claims and Larceny by False Pretenses. Both defendants entered a plea of not guilty before Clerk Magistrate Wong and were released on personal recognizance.
In May 2008, the Attorney General's Office began an investigation after the matter was referred by the Office of the State Auditor's Bureau of Special Investigations (BSI).
Beginning in 2003, Mohamoud applied for and was approved to receive PCA services to be paid for by MassHealth. Authorities allege that Mohamoud's intent was to obtain the money that the people she purportedly hired as her PCAs would receive from MassHealth, and not the services. During the time period 2003 to 2009, Mohamoud schemed with several of the people she hired to be her PCA's to submit false timesheets claiming that they worked over 30 hours per week assisting Mohamoud with daily living needs, when they did little or no PCA work. Mohamoud allegedly kept Medicaid money that was supposed to be paid entirely to the PCA's, either by setting up joint bank accounts with the PCA and arranging for the Medicaid money to be directly deposited into a joint account, or, if the PCA was paid by check, having the PCA give her some or all of the money back in the form of cash or check. In total, investigators discovered that Mohamoud's false billing scheme resulted in over $120,000 worth of false billings to MassHealth.
Investigators also discovered that from July 2003 to October 2004, Africa Mohamud knowingly participated in and profited from his sister Maryann's false billing scheme. Authorities allege that while supposedly providing his sister with PCA services, Africa Mohamud had a full time job in Boston, approximately two hours away from his sister's home. Nonetheless, Africa allegedly signed false timesheets and received direct deposits of Medicaid money into a joint account opened in his and his sister's name. Investigators discovered that during the timeframe Africa Mohamud participated in the scheme, the total amount billed to MassHealth was approximately $20,000.
Authorities allege that between October 2004 through November 2008, Saravia was supposedly providing PCA services to Mohamoud, yet he was employed full-time in two restaurants. Investigators discovered that Saravia allegedly signed false timesheets and, for four years, received direct deposits of Medicaid money into a joint account opened in his and Mohamoud's name. After the State Auditor's Office began its investigation, Mohamoud and Saravia changed the bank account to one in Saravia's name only. During the time Saravia participated in the scheme, the total amount billed to MassHealth was approximately $80,000.
The MassHealth program provides comprehensive health insurance to more than one million Massachusetts children, families, seniors, and people with disabilities (referred to as "consumers"). Once approved to receive MassHealth benefits, a consumer with long-term disabilities may further qualify to participate in the Personal Care Attendant (PCA) program. The PCA program is designed to enable disabled consumers to live at home by providing them with funds to hire a person, the PCA, to help them with certain daily living activities.
A Suffolk County Grand Jury returned indictments against all three defendants on September 30. Maryann Mohamoud, Africa Mohamud, and Oscar Saravia are scheduled to return to court on December 3, 2010 for a pre-trial hearing.
The case is being prosecuted by Assistant Attorney General Nancy Maroney and was investigated by Investigator Meaghan Fogaren, both of Attorney General Martha Coakley's Medicaid Fraud Division, in collaboration with investigators from the Bureau of Special Investigations of the Office of the State Auditor and the Boston office of the U.S. Department of Health and Human Services of the Inspector General. MassHealth also assisted in the Attorney General's investigation.