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Nothing Holy About Fraud

Nothing Holy About Fraud

Medicaid
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Kabiwa admitted in court that she and her co-conspirators paid bribes and kickbacks to Medicaid beneficiaries to encourage them to visit her facility Holy Health for mental health services. Encouraged meaning, Kabiwa and her co-conspirators drove the Medicaid beneficiaries to the Holy Health’s clinics themselves. And then upon arriving at the clinic, Kabiwa would pay$5 or $10 cash bribes to the visiting Medicaid beneficiaries in exchange for describing the payments as a transportation stipend. Which is a U.S. government covered benefits! Kabiwa concealed the illegal bribes as payments by using a nonprofit she had founded called the Agatha Foundation. Kabiwa provided front desk employees of Holy Health with sign-in sheets containing Agatha Foundation letterhead to create the false appearance that Agatha was making the payments.

For each visitor that Kabiwa bribed, Kabiwa would bill Medicaid a variety of mental health services including “community support” – a service for which community support workers (“CSWs”) provide rehabilitative and educational support to mental health patients. In total, the loss to Medicaid for all of the Holy Health services that were not delivered or procured via bribes and kickbacks amounted to at least $3,343,781.

Like all fraudsters did during the pandemic, Kabiwa also fraudulently obtained an Economic Injury Disaster Loan for Holy Health of $150,000. But she didn’t use it for Holy Health. Within days of the receipt of the loan, Kabiwa transferred $120,000 of the EIDL funds to her personal bank account. She admitted using the money to pay for personal items, including the purchase of two vehicles, one of which was a Porsche Cayenne.

On July 17, 2023, Kabiwa was found guilty and is due back in federal court on Nov. 21 for sentencing. Shout out to the COVID-19 Fraud Enforcement Task Team on this case.

Today’s Fraud of The Day is based on article “Guilty Plea For Silver Spring Woman Charged In Healthcare Fraud Scheme” published by The Patch on July 17, 2023

SILVER SPRING, MD — A 45-year-old Silver Spring woman pleaded guilty Wednesday to conspiracy to commit health care fraud as part of a scheme to pay bribes and kickbacks to Medicaid beneficiaries to entice them into visiting one of the mental health service providers she operated in Washington, D.C., according to the U.S. Department of Justice.

As owners and operators of Holy Health Care Services, LLC, Mboutchock Kabiwa, also known as Eugenie Bakari or Eugenie Kabiwa, and a co-conspirator entered into Medicaid provider agreements with the District’s Department of Health Care Finance, according to Kabiwa’s plea agreement. The company agreed to provide healthcare services to Medicaid recipients in the city. It also was certified with the district’s behavioral health department to provide health services as a freestanding clinic and as a provider of mental health and rehabilitation services.

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