Maryland Man Sentenced for Defrauding the D.C. Medicaid Program

            WASHINGTON - Melchiades Amin, 45, of Glenn Dale, Maryland, was sentenced today, May 11, 2023, to serve 36 months of incarceration, suspended, and five years of probation.  Additionally, the Honorable Andrea Hertzfeld ordered Amin to pay $178,150.24 in restitution to the D.C. Medicaid program.  The sentence was announced by U.S. Attorney Matthew M. Graves and Daniel W. Lucas, Inspector General for the District of Columbia.

            Amin was indicted on October 26, 2022, and he was arrested on November 2, 2022.  On March 10, 2023, Amin pleaded guilty in D.C. Superior Court to one count of First-Degree Felony Fraud and two counts of First-Degree Felony theft.

            According to the government’s evidence, between May 2018 and on or about October 2021, Amin was employed by two District Mental Health Rehabilitation Service (MHRS) providers as a community support worker (CSW).  MHRS provides for diagnostic and assessment services, counseling, medication, intensive day treatment, and crisis or emergency services.  A CSW provides community support services by helping consumers learn and improve basic life skills, such as medication management, increasing social skills, and learning how to use public transportation to travel when necessary.

            While employed by the two District MHRS providers, Amin engaged in a scheme to defraud the District’s Medicaid program. Employment records and records maintained by the District of Columbia’s Department of Behavioral Health show that Amin billed for overlapping encounter visits with MHRS patients, submitted patient notes indicating community support services had been provided in person while he was traveling out of state, submitted encounter notes for community support services while a patient was admitted in a hospital, and submitted encounter notes indicating community support services were provided at consumers’ homes while Amin may not have been at those physical locations. Through these schemes, Amin caused the D.C. Medicaid program to pay over $178,000 for CSW services that were not provided, of which he personally received more than $54,000.

            This prosecution is indicative of the continued collaboration between the U.S. Attorney’s Office and the D.C. Office of the Inspector General to investigate and prosecute cases of this kind.  The government urges the public to provide tips and assistance to stop health care fraud.  If you have information about individuals committing health care fraud, please call the D.C. Office of the Inspector General at (800) 724-TIPS [(800) 274-8477].

            In announcing the sentence, U.S. Attorney Graves and Inspector General Lucas commended the work of those who investigated and prosecuted the case from the Major Crimes Section of the U.S. Attorney’s Office for the District of Columbia and the Office of the Inspector General’s (OIG) Medicaid Fraud Control Unit (MFCU).  They commended the work of Special Assistant United States Attorney Emmanuela Charles, on detail from the Office of the Inspector General, who prosecuted the case, and also acknowledged the efforts of the OIG MFCU of those who investigated the case, including Auditor Pednika White, Special Agent Eduardo Torre, and Supervisory Investigator Robert Bornstein.