2 Charged in $3.2 Million Medicaid Fraud Scheme
BY MN CRIME STAFF
A multi-year Medicaid fraud scheme that prosecutors say generated more than $3.2 million in improper payments has led to felony charges against two people.
Authorities charged a Minneapolis home health care business owner and a supervising nurse at his agency, alleging both played key roles in the scheme.
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Mohamed Abdirashid Omarxeyd, 57, of Minneapolis, is charged in Hennepin County District Court with eight counts of theft by false representation. Prosecutors also charged Maryan Haji Garad, 41, of Minneapolis, with six felony counts in a separate but related case tied to the same scheme.
According to criminal complaints filed by the Minnesota Attorney General’s Office Medicaid Fraud Control Unit, Omarxeyd owned and operated Guardian Home Health Services Inc., a Medicaid-enrolled provider approved to bill for personal care assistance and waivered services. Investigators allege that between January 2020 and January 2024, Guardian submitted tens of thousands of fraudulent claims for services that were not provided, were provided by ineligible people or were billed in violation of state and federal Medicaid rules.
Prosecutors allege the false claims were submitted to the Minnesota Department of Human Services and managed care organizations including Medica, which relied on the submissions and paid out more than $3.2 million in Medicaid funds.
The complaints describe a pattern in which Guardian allegedly billed Medicaid for care while recipients were hospitalized, incarcerated or attending school, circumstances in which services could not legally be provided. Investigators also allege that services were billed during overnight hours when recipients were sleeping, for overlapping one-on-one care that could not physically occur and for work attributed to people who either never worked for Guardian or were working other jobs at the same time.
Garad is accused of aiding the scheme through her roles as Guardian’s qualified professional, designated coordinator and designated manager. Prosecutors allege that in those positions, she was responsible for overseeing patient care, completing care plans and supervising services required for Medicaid reimbursement, but instead helped create the appearance of compliance while those requirements were not met.
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Garad’s complaint alleges she signed blank or incomplete care plans and supervision documents, collected signature pages without completing required assessments and failed to conduct or document mandatory supervisory visits. Prosecutors say those actions allowed Guardian to bill Medicaid for $539,000 in services that would not have been reimbursed had the lack of supervision and documentation been known.
In Omarxeyd’s case, investigators say the operation relied heavily on blank or incomplete timesheets signed by caregivers or responsible parties at his direction. Those documents were later filled in with hours and services that did not reflect what actually occurred. Multiple caregivers and recipients told investigators they were instructed how to bill in ways that maximized payment regardless of whether services were performed.
Financial records reviewed by investigators show Omarxeyd personally received large sums from Guardian accounts, including salary payments, transfers to accounts he controlled and significant cash withdrawals. The complaint also alleges Guardian paid hundreds of thousands of dollars to Omarxeyd’s wife, despite her not being listed as an owner or employee of the agency.
Garad is charged with four counts of theft by false representation over $35,000, one count over $5,000, and one count of theft by false representation of public funds.
Omarxeyd is charged with eight counts of theft by false representation over $35,000.
Each theft count involving more than $35,000 carries a maximum sentence of up to 20 years in prison. The two remaining felony counts Garad faces each carry a maximum sentence of up to five years. Both were charged by summons and are scheduled to appear in court on Feb. 3.
