Two Twin Cities men allegedly defrauded the state’s Medicaid program of hundreds of thousands of dollars by billing it for patient care assistant services that were never provided, according to charges.
Kaldeq Yusuf and Abdifatah Ali, who ran a company together, allegedly billed the state using the names of real patient care assistant (PCA) providers who never worked for them and the names of people who never worked as a PCA. They also allegedly used the identities of real PCAs who had worked for them long after they had quit.
Authorities allege that between July 2014 and June 2016, the two defrauded the state of $400,494.
Yusuf, 33, of Hopkins, and Ali, 39, of Eagan, were each charged Thursday in Hennepin County District Court with five felony counts: four counts of aiding and abetting theft by false representation and one count of aiding and abetting identity theft.
After mid-2015, Yusuf was the sole owner of Diversity Home Healthcare Inc., a Minneapolis company which served as an intermediary between the state and clients receiving PCA care. Ali was the brother of the company’s previous co-owner and served as a manager, but allegedly masterminded the fraud, according to the charges. The previous co-owner was not charged in the alleged fraud.
Medicaid pays for PCA services such as food preparation, grocery shopping, housekeeping and help with hygiene and medication. The state contracts with companies, such as Diversity, that provide the PCAs and report their work hours to the state in exchange for payment.
According to the criminal complaint: Yusuf allegedly told an investigator that Ali trained the PCAs and did most of the company’s billing from 2014 onward. Records showed that Yusuf had also signed several forms billing the state for payment.
Yusuf was listed as the company’s biller; Ali was not. Both had access to the company’s bank accounts and ATM card.
Witnesses including the mother of a child who received PCA care through Diversity, the company’s registered nurse and staff members allegedly told investigators that Ali was the company’s “boss,” billed the state for money and asked clients to sign multiple time sheets for care that had not been provided.
Witnesses also allegedly said that Ali would give clients and PCAs cash to split among themselves, the charges said.
The company allegedly used former PCAs’ names to bill the state for as long as a year after they had quit, in one case receiving more than $45,000 for one person. They also allegedly billed the state for work from five people on the company’s payroll who were never enrolled with the company as a PCA.
The investigation was conducted by the Minnesota Attorney General’s Office and Department of Human Services.
Yusuf and Ali were charged via summons and will be allowed to turn themselves in at a future date to be booked and released from the sheriff’s custody. Their first court appearance is scheduled for Nov. 19. Neither could be reached for comment, and neither had an attorney listed for their case.