Fraudsters Of Medicare And Medicaid Paying The Price For Their Illegal Actions


Caregivers of the elderly are special people. Needless to say, they perform extremely important jobs that are nowhere near easy. Naturally, it takes a kind, considerate and patient person to assist with the needs of an older adult. Sadly, not every personal care worker has admirable attributes.


Maryland personal care aid charged with defrauding Medicaid.


50 year-old Joseph Tamjong worked as a personal care aide in the District of Columbia. As its branch of the United States Department of Justice announced last week, the Maryland resident was arrested for defrauding the D.C. Medicaid program out of hundreds of thousands of dollars. According to the report, Tamjong bilked Medicaid out of more than $700, 000 for personal care aide services he purported to provide.

As the DoJ report reveals, Tamjong has been employed as a personal care aide since December of 2014. He also functioned as a participant-directed worker to provide personal care aide services to District of Columbia residents. Among his duties were helping care recipients with getting in and out of bed, bathing, dressing and eating.


“Tamjong is alleged to have submitted false timesheets claiming that he provided such services when in fact he did not, including when he was traveling outside the United States on eight different trips,” reports the DoJ, “Charging documents allege that between December 2014 and February 2022, Medicaid issued payments totaling approximately $733,405 for personal care aide services that Tamjong purportedly provided as a personal care aide or participant-directed worker.”


North Carolina nurse practitioner pleads guilty to defrauding Medicare.


Last week, the Western District of North Carolina DoJ branch reported that 44 year-old Justin Segrest pleaded guilty to a conspiracy charge. The Mount Airy nurse practitioner defrauded Medicare of nearly $15 million via a durable medical equipment (DME) scheme. According to filed documents, Segrest caused thousands of claims to be submitted to Medicare for medically unnecessary orthopedic braces and other DME.


He worked in Delaware between 2018 and 2019. During that time, he made false claims in medical records to support his fraudulent claims. “He did so by signing false medical records describing purported ‘assessments’ of Medicare beneficiaries and certifying that he had performed corresponding medical examinations when, in fact, Segrest had no interaction with the beneficiaries and made no medical determination whether the devices were medically necessary or the beneficiaries needed the DME,” the DoJ reports.


From a telemedicine company, Segrest received unsigned orders for orthopedic braces for the beneficiaries. He signed them and returned them to the telemedicine company in exchange for $15 for each purported assessment that he performed. After his June 30th plea hearing, Segrest was released on bond. He faces a maximum prison term of five years and a $250,000 fine for the conspiracy charge. Sentencing has not yet been set.


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