February 20, 2020

U.S. Attorney’s Office for the Southern District of New York Charges 13 in $20 Million Medicaid Fraud Scheme

In a complaint unsealed on February 14, the United States Attorney’s Office for the Southern District of New York charged 13 individuals with participating in a scheme to steal millions of dollars from New York State’s Medicaid Program by submitting more than 100,000 fraudulent claims for transportation services.  The Medicaid Program pays for certain non-emergency transportation costs related to medical care, such as the cost of a patient’s transportation to and from a doctor’s office.  From August 2017 to February 2020, KJ Transportation C Services (KJ) received more than $20 million in Medicaid reimbursements for fraudulent transportation claims, including claims for which the Medicaid recipient was either deceased, out of the country, or where the Medicaid recipient had never heard of KJ.  In other instances, Medicaid recipients allegedly received illegal kickbacks for giving Medicaid information to KJ, or for scheduling medical-related trips that never took place.  The owner and manager of KJ are charged with submitting false or fictitious claims, theft of government funds, wire fraud, health care fraud, aggravated identity theft, violation of the anti-kickback statute, and money laundering.  Eleven other individuals who acted as drivers or recruiters of Medicaid enrollees are charged with all of the same offenses other than money laundering.