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Knowing Right from Wrong

Healthcare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

You would think that a licensed attorney would know better than to commit Medicaid fraud. After all, lawyers are experts in knowing right from wrong. (Or at least you would think so.) Licensed attorney Susan Engonwei Tingwei, 44, of Silver Spring, Md., pleaded guilty to defrauding the District of Columbia (D.C.) Medicaid program out of more than $100,000 by submitting false claims about personal care services.

Over two years, Tingwei was employed by two different home health agencies in D.C. She assisted Medicaid beneficiaries with performing activities of daily living, such as getting in and out of bed, bathing, dressing, and eating. She was required to document the care she provided to the Medicaid beneficiaries on timesheets, then submit them to her employers. Those home health agencies would then bill Medicaid for the services rendered. (As you might guess, Tingwei lied on the timesheets. She claimed to provide services, but she did not.)

On 118 occasions, Tingwei submitted timesheets between August 2016 and May 2017 that claimed she worked as a personal care aide in Washington, D.C. During those same times that she claimed she was providing care, she was either attending law school classes in Baltimore, or traveling to and from Baltimore for her law school program. (Records show Tingwei’s key card swiping in at the University of Maryland’s law school campus during days she was supposedly working in Washington, D.C. and cell phone records showed her cell phone ringing in Baltimore on days she claimed she was providing in-home care.)

Tingwei’s fraud scheme began before she graduated with her Master of Laws degree in May 2017 and it continued after she was admitted to the New York state bar in February 2018. (You know she knew right from wrong but she continued to do the wrong thing any way.) She successfully defrauded the D.C. Medicaid program out of $131,656.

Tingwei pleaded guilty to health care fraud, which could get her a maximum of 10 years behind bars and financial penalties. She likely faces a sentence of between 10 and 16 months in prison and financial penalties. She agreed to pay $131,656.12 in restitution. (Let’s hope she now understands the difference between right and wrong.)

If you have any information about individuals committing health care fraud, please call the Department of Health and Human Services’ Office of Inspector General hotline at (800) HHS‑TIPS (800) 447-8477 or the D.C. Office of the Inspector General at (800) 724-TIPS (800) 274-8477.

Today’s Fraud of the Day comes from a Department of Justice press release, “Licensed Attorney Pleads Guilty to Defrauding Medicaid in Scheme Involving Personal Care Services,” dated November 19, 2021.

WASHINGTON – Susan Engonwei Tingwei, 44, of Silver Spring, Md., a licensed attorney, pleaded guilty today to defrauding the D.C. Medicaid program out of more than $100,000 in a scheme involving false claims about personal care services.

The announcement was made by U.S. Attorney Matthew M. Graves, Wayne A. Jacobs, Special Agent in Charge of the FBI Washington Field Office’s 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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