Most able-bodied people are capable of getting to doctor appointments on their own. An automobile, taxicab, bus, bike or train can usually get them there on time. However, convalescents or handicapped individuals often use an ambulette service, which provides a specially equipped motor vehicle for transporting recovering patients or the physically disabled. The Village Voice reports on a man who participated in a $13 million health care fraud scheme that took some Medicaid beneficiaries on a ride by paying and accepting illegal health care kickback payments through his ambulette transportation service.
The story reports that the man enticed Medicaid beneficiaries to obtain medical services, which they did not need. The fraudster transported the beneficiaries to a Brooklyn clinic, where he paid the employees a per-beneficiary cash kickback so that the medical clinic would accept the ambulette service’s beneficiaries as patients. The ambulette company then billed Medicaid for the transportation of the patients to and from their homes and the clinic. Once the beneficiaries were transported to the clinic, the man would pay the beneficiaries to continue to attend the clinic for medically unnecessary treatment including physician office visits, medical procedures, physical therapy and diagnostic testing. The medical clinic allegedly got their cut of the fraud pie by billing Medicare and Medicaid for the unneeded services.
The 57-year-old, who has pleaded guilty, is one of seven defendants in this fraud case which included other patient recruiters, the medical facility manager and clinic medical director. He now faces sentencing for his part in the elaborate kickback scheme. He will face up to five years in prison, $850,000 in fines, $429,000 in restitution and $429,000 in forfeiture.
The Medicare Fraud Strike Force scores again. Since its beginning in 2007, the organization has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. This fraudster tried to take U.S. taxpayers on a ride as well, but it looks like this guy will be taking a ride in a paddy wagon, straight to jail.