Unexpected Discovery of Medicaid Fraud
What began as a routine review of her Medicaid billing turned into a startling revelation for Erna Hammerschmidt, a Minnesota resident who has worked hard to rebuild her life after overcoming addiction. To her shock, she discovered that her name had been used to perpetrate what she considers fraudulent activities.
Ghost Billing by Unknown Providers
“It felt strange,” Erna recounted. “I came across claims for a company called Community Care Partners and thought, ‘Who are these people?’” The unfamiliar entity had billed her Medicaid insurance multiple times a week for a total of $188.90, citing the provision of Adult Rehabilitative Mental Health Services (ARMHS).
Background on ARMHS and the Fraud Crisis
The ARMHS program, which aims to support individuals in achieving psychiatric stability and enhancing social skills, is overseen by the beleaguered Minnesota Department of Human Services. This department has faced significant criticism for its inability to prevent widespread fraud in programs intended to assist individuals battling addiction and homelessness.
An Uneasy Life of Recovery
Erna now embraces a quieter life in rural Minnesota, waking up to the sound of roosters and enjoying the simplicity of her new home on the outskirts of Oak Grove. Having battled addiction for 15 years, she is proud to be two years sober and attributes much of her success to publicly funded rehabilitation and Housing Stabilization Services (HSS) programs that helped her find stability.
Widespread Allegations of Fraud
As investigations by KARE 11 unveiled numerous fraud cases within these assistance programs, Erna took the precaution of examining her own Medicaid claims. It was during this review that she uncovered thousands of dollars billed by Community Care Partners, a name she did not recognize.
Community Care Partners Under Scrutiny
Despite multiple charges appearing weekly on her Medicaid account, Erna confirmed she had never received services from Community Care Partners. “I absolutely feel that fraud has been committed,” she asserted upon realizing the magnitude of the situation.
Owner Acknowledges Fraudulent Activities
Following her claims, Mohamed Mohamed, one of the new owners of Community Care Partners, reached out via email to confirm the fraudulent billing had occurred. He stated that upon learning of the allegations, they conducted an internal review, leading to the immediate termination of the responsible staff member. Mohamed also expressed concern over what he perceived as targeted scrutiny of his business based on ethnicity and religion.
A Broader Perspective on Medicaid Fraud
For Erna, this experience has starkly illustrated the vulnerabilities in programs designed to provide support. “Services like this will eventually become limited or nonexistent because of incidents like this,” she lamented, adding a sense of urgency to address the ongoing issue of fraud in Medicaid-funded programs. “It may not affect me directly today, but at the end of the day, someone has to pay for it,” she noted, highlighting the broader implications of such fraudulent activities.
This ongoing situation showcases the urgent need for comprehensive reforms in the integrity of Medicaid systems. As KARE 11 continues its investigations, further updates will be shared about the dynamics of fraud affecting Minnesota’s vulnerable populations.
