Category: United States of America

Source: US State of New York

EW YORK – New York Attorney General Letitia James today announced a major takedown of 25 transportation companies throughout the state for schemes to steal millions of dollars from Medicaid. In January, Attorney General James announced new investigations into transportation companies that are reimbursed by Medicaid for taking patients to and from health care appointments. As a result of these Office of the Attorney General (OAG) investigations, 16 transportation companies will pay back more than $13 million. In addition, OAG has filed new lawsuits against seven transportation companies for defrauding Medicaid and secured the convictions of two individuals and their companies for their roles in medical transportation fraud schemes. Today’s statewide takedown includes companies located in New York City, the Capital Region, Western New York, Westchester County, Central New York, and on Long Island.

“When companies make up fake bills and exploit patients to overcharge Medicaid, they take resources away from a program that allows the most vulnerable New Yorkers to get health care,” said Attorney General James. “My office launched a sweeping investigation of the medical transportation industry to root out fraud, and we are getting results. From Buffalo to the Bronx, we’re holding scammers accountable and returning millions of dollars in stolen funds to Medicaid, a taxpayer funded program. I will continue to go after anyone who tries to profit by undermining our health care system.”

Medicaid reimburses authorized businesses for transporting Medicaid patients to and from covered medical services. A licensed taxi company enrolls with the state as an eligible provider and is then randomly assigned to provide trips to patients to specific, non-emergency, medical appointments. The companies must use licensed drivers, proper vehicles, and bill only for services actually rendered. They are allowed to bill Medicaid for a base rate for the trip, plus an amount for mileage and any tolls.

The OAG’s Medicaid Fraud Control Unit (MFCU) has investigated transportation companies across the state for using fake billing and other fraudulent tactics to steal Medicaid funds. The companies’ schemes often involve billing Medicaid for fake trips, adding fake tolls to inflate costs, fraudulently extending the mileage of trips, and using unlicensed drivers. In some cases, companies exploit vulnerable Medicaid recipients by paying them kickbacks in exchange for requesting transportation services from the company. These kickback schemes can put already vulnerable New Yorkers at even greater risk. MFCU investigators have uncovered cases in which transportation companies exploited Medicaid recipients in need of substance abuse treatment to recruit passengers to use in fake billing schemes.

Attorney General James today announced that OAG has secured 16 settlements with transportation companies worth a combined $13 million:

• American Base No. 1, a Bronx-based company, will pay $4,775,869.61 to resolve civil and criminal allegations that the company operated illegally to steal millions of dollars from Medicaid. MFCU’s investigation found, among other things, that the mileage claimed by American Base drivers was grossly inflated, as they billed vastly more paid trip miles than their vehicle odometers read at mandatory NYC Taxi and Limousine Commission (TLC) inspections. American Base drivers also claimed impossible amounts of daily services, such as one driver who claimed 96 unique trips amounting to 2,158 miles during just one day. Many Medicaid patients whom American Base claimed to bill for had never heard of the company nor actually used Medicaid taxi services, and others admitted to being paid kickbacks by drivers to request rides from American Base.
• Agape Luxury Corp, a Bronx-based company, paid $2.45 million to resolve allegations that the company falsely increased the mileage of its trips that it submitted for reimbursement to Medicaid. Agape also failed to follow New York City TLC requirements for legal operation and failed to maintain legally required records.
• NBT Transportation, a Bronx-based company, paid $1,516,617.00 to resolve allegations that the company submitted claims to Medicaid for fake toll expenses.
• Angel Medical Transportation, a Schenectady-based company, paid $1.1 million to resolve allegations that the company submitted claims to Medicaid for transportation services that did not occur and that were provided by drivers who lacked proper licenses.
• Lakeview Global, a Clarence-based company, paid $684,308.18 to resolve allegations that the company claimed trips that did not occur or used false addresses that resulted in excess payments.
• U.S. Trips and Trade, a Westchester-based company, paid $500,000 to resolve allegations that the company submitted inflated and fake tolls for reimbursement from Medicaid.
• Buzz Transport, a Hudson-based company, paid $363,995 to resolve allegations that the company submitted claims to Medicaid for fake tolls.
• JD Express, a Forest Hills-based company, paid $331,000 to resolve allegations that the company submitted claims to Medicaid for fake toll expenses and transportation services provided by unlicensed, under-licensed or suspended drivers.
• Vic and Bay Care Service, a Staten Island-based company, paid $250,000 to resolve allegations that the company submitted claims to Medicaid for transportation services that did not occur.
• Divine Hearts Transportation, a North Tonawanda-based company, paid $227,010.34 to resolve allegations of overbilling for false addresses and fictitious trips.
• Equaltrans, a Bronx-based company, paid $224,892.01 to resolve allegations that the company submitted claims to Medicare for transportation services that did not occur as described on the claim.
• KFH Medicaid Transportation, an Amherst-based company, paid $143,760.37 to resolve allegations that the company submitted fake rides for reimbursement from Medicaid. The company has since ceased operation.
• Shamrock Transportation, an Orange County-based company, paid $147,680 to resolve allegations that the company submitted inflated and fake tolls for reimbursement from Medicaid.
• Interstate Luxury Limousines, a Bronx-based company, paid $142,389.25 to resolve allegations that the company submitted claims to Medicaid for transportation services that did not occur as described on the claim.
• Lak Sam, a Glenmont-based company, paid $119,708.88 to resolve allegations that the company submitted claims to Medicaid for transportation services that did not occur and for fake tolls.
• A Nice Ride, a Colonie-based company, paid $28,075.43 to resolve allegations that the company submitted claims to Medicaid for transportation services and inflated toll payments.

In addition, Attorney General James today announced lawsuits against seven transportation companies that were sent cease and desist letters earlier this year but have failed to comply and continued fraudulent practices:

• Green Cab BNY, a Cheektowaga-based company, was sued for allegedly billing Medicaid for trips with falsely inflated mileage. The lawsuit seeks monetary damages of at least $2,385,398.54.
• Dutchess Black Car Service, a Lagrangeville-based company, was sued for submitting claims for transportation services that did not occur, and for submitting claims for tolls that were not incurred or where the cost of the toll was inflated. The lawsuit seeks monetary damages of at least $2,276,850.28, as well as civil penalties. An affiliated company, Westchester County Black Car Service, operating out of the same address, was also sued for submitting claims for transportation services that did not occur, and for tolls that were not incurred or where the cost of the toll was inflated. The lawsuit seeks monetary damages of at least $1,157,127.86, as well as civil penalties.
• Buffalo Taxi Services, an Amherst-based company, was sued for allegedly billing Medicaid for trips that never actually happened. The lawsuit seeks monetary damages of at least $1,691,714.04.
• Seaman Radio Dispatchers, a Manhattan-based company, was sued for submitting claims for the transportation of Medicaid beneficiaries who were deceased, for claiming payment for rides that never took place, and claiming payment while the company’s NYC TLC base license was suspended. The lawsuit seeks monetary damages of at least $1,235,514.76.
• TemboCare Transportation Express, a Saratoga County-based company, was sued for repeatedly submitting claims for payment to Medicaid with falsified pickup or drop off locations to inflate the mileage of the trips for which they billed and for falsely using Ngowi’s driver’s license information for trips claimed when Ngowi was clocked in for duties elsewhere as a New York state employee. The lawsuit seeks monetary damages of at least $294,982.18.
• SMI Transportation, a Buffalo-based company, was sued for allegedly billing Medicaid for trips with falsely inflated mileage and for using a driver to provide transportation services who had been previously excluded from providing Medicaid services due to a prior criminal conviction for Medicaid fraud. The lawsuit seeks monetary damages of at least $96,827.10.

Attorney General James today also announced that three individuals have been charged or convicted as a result of OAG investigations into medical transportation fraud:

• David Moore, 56, of Interlaken pleaded guilty to Grand Larceny. As the owner of ASAP 2, a transportation company, Moore submitted claims for payment to Medicaid that were the result of unlawful kickback payments to multiple Medicaid recipients and which were also falsely inflated by substantially increasing the claimed mileage for trips that were taken. Medicaid paid ASAP 2 over $50,000 based on these false and fraudulent claims.
• James Bessell, 65, of Shirley was charged with Grand Larceny, Health Care Fraud, Offering a False Instrument for Filing, and payment of kickbacks for his role in a Medicaid fraud scheme. Bessell owned Jim Jim Rentals, which billed Medicaid for transportation services that were never actually provided, causing Medicaid to pay Jim Jim Rentals over $1 million. Bessell also operated an illegal kickback scheme, paying Medicaid recipients for their purported use of his transportation services.
• Jose Ortiz, 63, of the Bronx, the owner of American Base, was charged and pleaded guilty to Offering a False Instrument for Filing in the Second Degree, a felony, in connection with the unlawful operations of that company.

These charges are merely accusations, and the defendant is presumed innocent unless and until proven guilty in a court of law.

Attorney General James thanks the United States Department of Health and Human Services – Office of the Inspector General, the New York State Department of Health, and the Office of the Medicaid Inspector General for their cooperation in these investigations.

These investigations were conducted by Auditor-Investigators and Data Analysts led by MFCU Chief Auditor Dejan Budimir, MFCU Detectives led by Deputy Chief  Ronald Lynch, Acting Commanding Officer, MFCU, and the MFCU Regional Directors, Special Assistant Attorneys General, and legal support analysts from each of the Medicaid Fraud Control Unit’s seven regional offices, coordinated by MFCU Chief of Criminal Investigations Thomas O’Hanlon and MFCU Chief of Civil Enforcement Alee Scott and AAGs Emily Auletta and Nathan Shi. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney. The Division of Criminal Justice is led by Chief Deputy Attorney General José Maldonado under the oversight of First Deputy Attorney General Jennifer Levy.

Reporting Medicaid Provider Fraud: MFCU defends the public by addressing Medicaid provider fraud and protecting nursing home residents from abuse and neglect. If an individual believes they have information about Medicaid provider fraud or about an incident of abuse or neglect of a nursing home resident, they can file a confidential complaint online or call the MFCU hotline at (800) 771-7755. If the situation is an emergency, please call 911.

New York MFCU’s total funding for federal fiscal year (FY) 2025 is $70,502,916. Of that total, 75 percent, or $52,877,188, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $17,625,728 for FY 2025, is funded by New York State.

If you need assistance obtaining Medicaid transportation services, you can contact New York’s Medical Transportation Broker at the following numbers: NYC, Long Island and Westchester: 844-666-6270; Upstate: 866-932-7740 or using the MAS website. 

MIL OSI USA News –