Double-booked

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Calculator and stethoscope on paperwork

Folashade Adufe Horne, 51, of Laurel, Md., claimed she was in two places at one time on multiple occasions. These lies allowed her to steal more than $370,000 from the Washington, D.C. Medicaid program in a fraud scheme that occurred between January 2014 and June 2020.

While Horne was employed full-time by Howard University, she was also employed by four different home health agencies as a personal care aide for District of Columbia Medicaid beneficiaries. (She was a very, very busy lady.) Horne supposedly helped her clients to perform daily living activities such as getting in and out of bed, bathing, dressing and eating.

Horne purportedly documented the services she provided to the Medicaid beneficiaries through timesheets, then submitted them to her employers. Those agencies then submitted bills to Medicaid for payment based on the services Horne claimed she performed. As you might guess, she submitted fake timesheets to the home health agencies. (She was actually working shifts as a full-time employee at Howard University Hospital.)

She got pretty creative with her timesheet submissions. On more than 200 occasions, she claimed to work more than 20 hours during a given day. (Including 28 days when she said she provided 32 hours of personal care services. I’m not a rocket scientist, but there are only 24 hours in a day.) She also claimed she provided personal care services in the District of Columbia when she was out of the country. (Perhaps she has a twin.)

Horne eventually acknowledged that she caused the D.C. Medicaid Program to issue payments totaling $373,564 for work she did not perform. Her crime carries a statutory maximum of 10 years behind bars and additional financial penalties. (Most likely she’ll face a sentence of between 18 and 24 months.)

This crime is just one of many that have tried to defraud the government healthcare program. Thanks to the FBI, Department of Health and Human Services’ Office of Inspector General, the District of Columbia’s office of the Inspector General’s Medicaid Fraud Control Unit, and the U.S. Attorney’s office, six other former personal care aides have been sentenced for defrauding Medicaid since October 2019, while cases against two others remain outstanding.

The government relies on the public to provide tips or assistance on health care fraud. If you have any information about anyone committing health care fraud, please contact the Department of Health and Human Services’ Office of Inspector General hotline at (800) HHS‑TIPS [(800) 447-8477.

Today’s Fraud of the Day comes from a Department of Justice press release, “Howard University Employee Pleads Guilty to Healthcare Fraud Government Continues Crackdown on People Who Defraud Medicaid,” dated February 25, 2021.

WASHINGTON – Folashade Adufe Horne, 51, of Laurel, Maryland, pled guilty on February 17, 2021 in federal court to defrauding the D.C. Medicaid program out of more than $370,000.

The announcement was made by Acting U.S. Attorney Michael R. Sherwin; James A. Dawson, Special Agent in Charge, FBI Washington Field Office, Criminal Division; Maureen R. Dixon, Special Agent in Charge of the U.S. Department of Health and Human Services’ Office of Inspector General for the region that includes Washington, D.C.; and Daniel W. Lucas, Inspector General for the District of Columbia.

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.