Putting the Brakes On

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Medicaid provides medical care to nearly 73 million individuals, but due to socioeconomic disadvantages, it is estimated that 3.6 million beneficiaries miss or delay care each year because of transportation issues. With that number of individuals requiring transportation to important medical appointments, you can understand why the president of a non-emergency medical transport company in New York, New York chose to commit Medicaid fraud. (Big pots of government money set aside for vulnerable beneficiaries attract greedy individuals who are determined to drive off with money they do not deserve.)

The owner of the New York non-emergency medical transport company stole $1.2 million in Medicaid funds by billing the government healthcare program for taxi rides that never occurred. The owner of the company falsely claimed that his company provided non-emergency medical transportation for Medicaid beneficiaries in compliance with the healthcare program’s rules and regulations. He knew all along that the transportation services were never provided or were provided in direct violation of the rules and regulations. (I’d expect nothing less from a fraudster.)

One of the transportation company’s drivers stole more than $7,500 from the Medicaid program. The taxi driver paid someone who happened to be working with investigators $100 to agree to receive “fake” services from the company. (Gotcha!) Then, he paid that person $300 for each week he continued to receive transportation services from the company. Also, during a three-week period, he submitted driver logs to the transportation company claiming he provided daily round-trip transportation for the Medicaid recipient between Jamestown and Buffalo. (That’s about 150 miles roundtrip each day that never occurred.) The $7,500 in Medicaid payments were based on the fake driver logs.

The New York transportation company owner pleaded guilty to Medicaid fraud and was sentenced to three years’ conditional discharge, plus 150 hours of community service for stealing $1.2 million from the Medicaid government healthcare program. The transportation company was ordered to pay a $10,000 fine, while the owner must pay restitution totaling $900,497.

The taxi driver also pleaded guilty to Medicaid fraud and was sentenced to two to four years in prison with a possibility of parole release supervision. He must pay $23,598 in restitution to the State of New York. (I bet he feels stupid. He drove off with $7,500, but now must pay back more than three times that amount.)

It’s estimated that Medicaid and other managed care plans pay $5 billion each year to transport Medicaid members to their healthcare appointments. Patients suffer greatly when a lack of transportation prevents essential medical care. (Missed check-ups, immunizations, or dialysis appointments can be life threatening.) Congratulations to New York’s Medicaid Fraud Control Unit for putting the brakes on this runaway transportation scam.

Today’s “Fraud of the Day” is based on an article entitled, “A.G. Underwood Announces Sentencing of Transportation Company, President, and Driver for Stealing $1.2 Million from Medicaid,” posted on LongIsland.com on October 16, 2018.

New York, NY – October 16, 2018 – Attorney General Barbara D. Underwood today announced that 716 Transportation, Inc., a Medicaid medical transportation provider, and its President Wossen Ambaye were sentenced today for stealing $1.2 million from the Medicaid program. Ambaye was sentenced to three years’ conditional discharge and 150 hours of community service by Erie County Supreme Court Judge John Michalski. 716 Transportation was sentenced to pay a fine of $10,000. As a condition of his plea, Ambaye was also required to pay $900,497 in restitution to the state.

Haimid Thompson, a.k.a. Mookie, a taxi driver for 716 Transportation, Inc., was also sentenced for stealing over $7,500 from the Medicaid program on September 28, 2018. Thompson, 48, of Jamestown, was sentenced as a Second Felony Offender to 2 to 4 years in prison with the possibility of parole release supervision by Erie County Supreme Court Judge Paul Wojtaszek. As a condition of his plea, Thompson was required to pay $23,598 in restitution to the state.

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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.