Approximately 80 million Americans depend on Medicaid for their healthcare coverage. The public health insurance program provides healthcare coverage to eligible low-income individuals and families. It also supports people with disabilities and certain other medical conditions as well as pregnant women and children.
Medicaid is the largest public health insurance program in the United States. It covers a wide range of healthcare services including doctor visits, hospitalization, prescription drugs and laboratory tests. It also covers long-term care services, such as nursing home care, for those who meet certain eligibility criteria. To be eligible for Medicaid, individuals must meet certain income and asset requirements. They vary by state.
Joseph Tamjong stole over $700,000 from the D.C. Medicaid program.
Medicaid has long been the victim of fraud. One of the latest perpetrators is a 51 year-old resident of Lanham, Maryland. As reported by the District of Columbia branch of the United States Department of Justice yesterday, Joseph Tamjong was sentenced to 20 months in prison for robbing the D.C. Medicaid program of $700,000. He will also serve three years of supervised release following his prison sentence. In addition, he will have to pay $733,405 in restitution and $396,155 in a forfeiture money judgment.
Tamjong pleaded guilty to one count of health care fraud on November 28, 2022. Between December 2014 and February 2022, he was employed as a Personal Care Aide and/or a Participant-Directed Worker. As part of his duties, Tamjong would provide personal care services to residents of the District of Columbia. These individuals needed assistance performing daily living activities including getting in and out of bed, bathing, dressing and eating.
Tamjong submitted false timesheets to Medicaid.
He claimed that he provided his services to Medicaid beneficiaries when, in actuality, he did not. Although most of his criminal activity was committed on U.S. soil, Tamjong also billed Medicaid for about 3,400 hours of services during times he was traveling outside of the country. His false claims were often outrageous in nature.
“On 156 separate occasions, he claimed he provided 24 hours of services in a single day,” reports the DoJ, “In total, he defrauded Medicaid of $733,405, personally receiving at least $395,155 in fraudulent wages from the scheme.”
Medicaid fraud is certainly not a victimless crime.
The financial costs of Medicaid fraud are substantial. Healthcare fraud costs Americans tens of billions of dollars each year. This money is siphoned away from legitimate healthcare services and programs. It can have a ripple effect on the entire healthcare system, leading to higher costs and reduced access to care for all Americans. In addition to the financial costs, Medicaid fraud can also have a direct impact on access to healthcare services for vulnerable populations.
When fraudulent providers or facilities are paid for services that were never provided or were unnecessary, it can drain resources from legitimate healthcare providers. This makes it more difficult for patients to access the care they need. This is particularly true for low-income individuals and families who depend on Medicaid for their healthcare coverage.
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