At Others’ Expense

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Non-emergency medical transportation (NEMT) plays a big role in keeping millions of Americans healthy. Without this vital service, many patients would not be able to receive a ride to their medical providers for care. A couple who operated a transportation company out of Binghamton, New York provided legitimate transportation services to many Medicaid patients, but they threw their employees under the bus. The deceptive duo committed Medicaid fraud by lying about carrying workers’ compensation insurance for their employees.

Professionals who provide NEMT services assist patients by helping them into and out of the vehicles. (Depending on the size of the person and their range of mobility, NEMT workers can be put at a higher risk of personal injury.) The Medicaid program requires NEMT providers to protect their employees by providing workers’ compensation insurance. (But, the husband and wife entrepreneurs lied to Medicaid and their employees about workers’ compensation coverage.)

Over a period of one-and-a-half years, the company legitimately provided transportation to medical appointments for Medicaid patients in Broome County, New York. But, during that time, they knowingly operated the NEMT company in violation of county transportation regulations and the New York State Workers’ Compensation Act. The defendants intentionally submitted license applications for the company that incorrectly claimed they possessed the required insurance. (They even attached bogus copies of insurance certificates listing insurance companies that didn’t actually provide workers’ compensation insurance.)

The 69-year-old husband pleaded guilty to Medicaid fraud and a workers’ compensation law violation. He was sentenced to five years of probation. His 65-year-old wife was sentenced to a one-year conditional discharge for her part in the illegal scam. As a result, the company had to forfeit $455,604 in Medicaid funds. The New Yorkers must also pay $50,000 in restitution each.

Fraud is always committed at others’ expense. The husband and wife team defrauded Medicaid, the government, and New York taxpayers, all at the expense of their employees’ safety. They also led regulators astray with the falsification of documentation that purported they covered their workers. (Just so they could save money on insurance premiums.) They undercut other businesses to make more money. While it looked like they were going to get away with their illegal scheme at first, they now get to pick up the tab for their medical transportation cabs.

Today’s “Fraud of the Day” is based on an article entitled, “Husband, wife avoid jail for Medicaid fraud,” posted on pressconnects.com on November 15, 2017.

A husband and wife from Binghamton who operated a transportation company avoided jail terms after pleading guilty in a Medicaid fraud case tied to their business operations.

Kenneth Cohn, 69, was sentenced to five years probation and Sharon Cohn, 65, was sentenced to a one year conditional discharge in Broome County Court. In October 2015, they were charged by the New York State Attorney General’s Office with obtaining more than $1 million in Medicaid payments while operating Yellow Medi-Van and Taxi, Inc., without workers’ compensation insurance.

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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.