A Blaine personal care assistant is at the center of a criminal case that prosecutors say involved a yearslong Medicaid billing scheme and more than 1,600 allegedly bogus claims. According to court documents, the claims stretch from June 2020 through June 2024 and are tied to about $182,547.41 in overpayments, with investigators alleging roughly $116,601.91 ultimately landed in the worker’s own accounts. The PCA, identified in Anoka County court filings as 41-year-old Shawki Mohamed Hamed Elsaid, has been criminally charged in that county.
How investigators say it worked
Investigators allege Elsaid used the identities of three people, including his ex-wife and two acquaintances, to submit hours and claims in their names to two local home-care providers, then routed the payments into his own bank accounts, according to FOX 9. The criminal complaint says a witness discovered his timesheets were used to bill far more hours than he actually worked, and that claims kept rolling in even when the listed caregivers or service recipients were out of state. Prosecutors say the alleged pattern produced 1,655 suspect claims spread over multiple six-month periods.
Why the state is watching home-care billing
The Minnesota Department of Human Services has labeled many in-home and waiver services as high risk and launched a statewide revalidation and pre-payment review effort meant to flag suspicious billing patterns, according to the Minnesota Department of Human Services. The agency outlines its program-integrity work and currently lists 14 service types in the high-risk category, including several waiver and PCA services. The Attorney General’s Medicaid Fraud Control Unit has also gone after larger provider cases this year, including charges tied to more than $3 million in alleged improper payments, as detailed by the Minnesota Attorney General's Office.
Investigation and next steps
The criminal complaint filed in Anoka County lists the alleged overpayments and describes several international trips investigators say Elsaid took while claims for services were still being submitted in his name. Prosecutors say the investigation started after Crystal police received a tip from his ex-wife, and that false claims were routed to two providers, Anytime Home Care in Golden Valley and Pride ’N’ Living in Fridley. Elsaid is charged with identity theft and theft by false representation and is scheduled to appear in Anoka County court, according to FOX 9.
Legal status
State prosecutors decide whether to pursue formal felony charges, restitution and other penalties, and larger fraud cases typically bring together the Attorney General’s Medicaid Fraud Control Unit and local law enforcement. The Attorney General’s office says it has prosecuted hundreds of Medicaid fraud cases and recovered tens of millions of dollars for taxpayers in recent years, highlighting a broader enforcement push, according to the Minnesota Attorney General's Office. Elsaid, like anyone accused of a crime, is presumed innocent until proven guilty in court.
How to report suspicious billing
If you suspect you or a family member were billed for hours or services that never happened, the Department of Human Services urges Minnesotans to report it. Tips can be submitted through the agency’s online form, by emailing [email protected], or by calling 651-431-2650 or 800-657-3750. Additional details on program integrity and how investigations unfold are available from the Minnesota Department of Human Services.
