No Free Rides

12

Medicaid pays for non-emergency ambulance transportation costs as long as a doctor provides a statement justifying the need for the service. (Medicaid beneficiaries are eligible for this service if they don’t have a working vehicle or a driver’s license; have a mental or physical disability; or are unable to travel or wait for a ride by themselves.)A co-owner of a Chicago-based non-emergency medical transport company tried to hitch a free ride on the government by overbilling Illinois’ Medicaid program by $4.7 million in services her company did not provide as claimed.

For about five-and-a-half years, the woman and her male co-owner submitted bills on behalf of deceased people and others they did not actually transport. They also charged the state’s Medicaid program for dates that the patients were approved for transportation, but did not actually ride. (Fraudulent claims were submitted despite the fact that the daily route sheets documented exactly who was transported.) In addition to billing for services not rendered, the fraudster and her co-conspirator also claimed excess mileage that was not actually driven.

The 44-year-old woman pleaded guilty to her role in the scheme and was sentenced to 30 months in prison. Her 67-year-old co-conspirator was convicted of conspiracy and seven counts of mail fraud. They were both ordered to each pay $4 million in restitution.

It doesn’t look like this fraudster will be driving anyone, much less herself, for the next 30 months. Her fraudulent scheme has finally run out of gas and she will be parked behind bars for a while. (That will definitely take the air out of your tires.)

Source: Today’s ”Fraud of the Day” is based on a Department of Justice press release entitled, ”Co-owner of Chicago Medical Transport Company Sentenced for Fraudulent Billing Scheme,” released on August 17, 2016.

Springfield, Ill. – A Chicago woman who previously pled guilty to her role in a scheme to overbill Illinois’ Medicaid program has been sentenced. On Aug. 15, 2016, U.S. District Judge Sue E. Myerscough ordered Tina Kimbrough, 44, of Berwyn, Ill., to serve 30 months in federal prison. Kimbrough and Gregory D. Toran, 67, of Hazel Crest, Ill., owned IBT Transportation, LLC., a non-emergency medical transport company, during the period of the fraud conspiracy, from December 2005 to June 2011.

Toran was convicted of the conspiracy and seven counts of mail fraud following a bench trial before Judge Myerscough, who rendered her guilty verdicts in late July 2016. Kimbrough was also ordered to pay $4 million in restitution, due jointly and severally with Toran, who is scheduled to be sentenced on Nov. 14, 2016. Kimbrough is to self-report as directed by the federal Bureau of Prisons to begin serving her prison term.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.