WASHINGTON (AP) — Twenty-five people were charged Thursday with obtaining at least $75 million in fraudulent Medicaid payments from the District of Columbia government, a series of cases that federal prosecutors said added up to the largest health-care fraud in the city's history.
The alleged schemes, which prosecutors said were similar but not necessarily part of a unified conspiracy, involved bogus claims for home care services, a category of Medicaid claim that has grown dramatically in the city over the past 8 years. The uptick in billings for home care — from $40 million in 2006 to $280 million last year — was part of what tipped off authorities to illegal activity, U.S. Attorney Ronald Machen said.
"We concluded that much of the growth was due to aggressive networks of fraudsters paying kickbacks to beneficiaries to manufacture false claims for nonexistent services," Machen said, later adding: "Medicaid fraud in the District of Columbia is at epidemic levels."
Prosecutors say many of the defendants persuaded patients to fake illness or injury so they could bill Medicaid for home care they didn't receive. Some of those patients received kickbacks, authorities said, although no patients have been charged. Those charged include the owners of home-care firms and nurse staffing agencies, home-care aides and recruiters who signed up patients.
Among those charged was Florence Bikundi, 51, of Bowie, Md., the owner of a home care agency who had lost her nursing license and was barred from participating in Medicaid. Authorities said that by using aliases, she was able to bill the city for $75 million in Medicaid payments.
Machen said it wasn't clear whether any of those payments went to legitimate home care services, but Bikundi was able to amass significant personal wealth, authorities said. Among the property seized from her were millions of dollars from 46 bank accounts, a 7,300-square-foot home valued at $927,000 and five luxury vehicles.
No attorney was listed in court records for Bikundi, who is in custody, and no one answered a call to her home Thursday afternoon.
Machen said there wasn't any particular weakness in the district's Medicaid program that made it vulnerable to bogus claims, and he noted that similar schemes have been perpetrated in other cities, including Detroit and Miami. The investigation is ongoing, and authorities said it was impossible to put a dollar amount on the fraudulent billings, although the indictments not involving Bikundi outlined schemes valued at less than $500,000.
"These numbers could likely grow. This is what we know so far," Machen said.
A dozen people were charged in five federal indictments that were unsealed Thursday. Thirteen others were charged with fraud in D.C. Superior Court. All but three were in custody Thursday afternoon, authorities said.
Many of those charged are immigrants from Cameroon in west Africa, but authorities did not go into detail about their nationalities.
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