Owner of Lewiston Counseling Agency Sentenced for Health Care Fraud
Portland, Maine: A Lewiston woman was sentenced today in federal court in Portland for conspiring to commit health care fraud, U.S. Attorney Halsey B. Frank announced.
U.S. District Judge Jon D. Levy sentenced Nancy Ludwig, 64, to 42 months in prison and three years of supervised release. Ludwig also was ordered to pay $660,902 in restitution to MaineCare. A jury had found Ludwig guilty of nine counts of health care fraud on June 14, 2019, after a five-day trial.
According to testimony at trial, Ludwig was the owner of Facing Change, a mental health and substance abuse counseling agency in Lewiston. Abdirashid Ahmed was a Somali interpreter. From about November 2015 until May 2018, Ludwig conspired with Ahmed and others to commit health care fraud. The evidence showed that beginning in February 2015, Ludwig agreed to pay Ahmed a kickback in return for Ahmed bringing MaineCare beneficiaries to Facing Change. Ludwig, Ahmed and other employees at Facing Change then submitted false claims to MaineCare for counseling and interpreter services. In 2016, in response to a MaineCare regulatory change, Ludwig and Ahmed conspired to change the diagnosis of many of those clients to schizophrenia so they could remain eligible to receive MaineCare reimbursement for services at Facing Change. In the fall of 2016, auditors with the MaineCare Program Integrity Unit audited Facing Change. Ludwig and many of her employees conspired to manufacture false records in an attempt to deceive the auditor. The fraud continued until May 1, 2018, when federal and state agents executed search warrants at Facing Change and Ahmed’s business.
The prosecution was the result of a three-year collaborative investigation conducted by the U.S. Department of Health and Human Services, Office of Inspector General; the FBI; and the Maine State Medicaid Fraud Control Unit. The investigation started because of the auditing work done by the MaineCare Program Integrity Unit.