Fraud Starts at Home

Man giving bribe to a doctor

Maryland resident Charlotte Etongwe pleaded guilty to defrauding the D.C. Medicaid program out of more than $250,000. She worked for eleven different home health agencies between July 2014 and March 2019 as a personal care aide. (None of her employers knew she was committing fraud right under their noses.)

Personal care aides are entrusted to assist Medicaid beneficiaries in carrying out daily activities that they are unable to do on their own. This includes simple tasks such as getting in and out of bed, bathing, dressing, and eating.  Etongwe abused her position by fraudulently billing D.C. Medicaid for services she did not provide. (We will soon see if Entongwe will be entrusted with an orange jumpsuit.)

Etongwe submitted timesheets to the home health agencies, who in turn billed Medicaid for the services she claimed she performed. However, the timesheets she submitted to the various home health agencies turned out to be false. The timesheets claimed Etongwe provided over twenty-two hours of home health care services that were never rendered. (That certainly can’t be explained away with a ‘long lunch break’ excuse.)

The hours submitted to the eleven different health agencies also depicted services that overlapped in hours. (Unless she learned how to be in two places at once, this isn’t remotely plausible.) Etonwe’s scheme cost the D.C. Medicaid Program $369,970 in fraudulent billings.

Etongwe faces a maximum of 10 years in federal prison for defrauding D.C.’s Medicaid program. She will most likely receive the recommended sentence of between 18 and 24 months and a fine of up to $75,000. (Hopefully, this amount of time will give her enough time to reform her fraudster ways.) Etongwe could also be required to pay restitution in the amount of her fraudulent billings.

If you suspect someone of committing healthcare fraud report them to the Department of Health and Human Services’ Office of Inspector General hotline at (800) 447-8477.

Today’s Fraud of the Day comes from a Department of Justice press release, “Maryland Woman Pleads Guilty to Health Care Fraud,” on September 9, 2020.

WASHINGTON – Charlotte Besumbu Etongwe, 45, of Beltsville, Maryland, pled guilty today in federal court to defrauding the D.C. Medicaid program out of more than a quarter million dollars.

The announcement was made by Acting U.S. Attorney Michael R. Sherwin; Robert E. Bornstein, Acting 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.