Six individuals have been charged in a fraudulent scheme that siphoned over $10 million from the D.C. Medicaid program, as confirmed by a recent indictment. Omolere Omomowo, 43, along with five community support workers (CSWs), stand accused of conspiring to bill for mental health services that were either not provided, not reimbursable, or medically unnecessary.

Arrested in Fort Lauderdale, Omomowo made an initial court appearance today in the U.S. District Court for the Southern District of Florida, as reported by the U.S. Attorney's Office for the District of Columbia. Zilah Bessem, another defendant, was detained at Dallas-Fort Worth International Airport and also faced court today in Texas. Awaiting their appearances, the remaining co-defendants are due to show up in D.C. court within the next week. In spite of the gravity of the situation, details on the exact scheduling for the appearances were not disclosed.

According to the indictment, the conspiracy kicked off in early 2020 when Omomowo, as the CFO of Prestige Healthcare Resources, oversaw the initiation of a more lucrative Assertive Community Treatment (ACT) program for mental health services. The indictment alleges a calculated move to inappropriately transition clients to the ACT program, inflating the severity of their mental health needs to justify higher and more frequent Medicaid billings.

Omomowo's resignation from Prestige in April 2021 did not end his alleged fraudulent activities. He quickly founded The Marcaulay Group and encouraged his former CSW colleagues to join him. Despite lacking the necessary certification, the group partnered with other healthcare providers to continue billing Medicaid using false assessments, according to the U.S. Attorney's Office. As patients transitioned to The Marcaulay Group, new assessments were required for continuing ACT program services. Authorities claim these assessments were falsified to sustain the flow of fraudulent claims.

If convicted, each person involved faces serious time, with conspiracy charges potentially leading to 20 years behind bars, while other offenses carry somewhat lesser sentences. As the case unfolds, led by officials from the Federal Bureau of Investigation and the D.C. Office of the Inspector General’s Medicaid Fraud Control Unit, and prosecuted by the U.S. Attorney’s Office.