By Robert Gavin
Three Western New York transportation companies have agreed to pay settlements exceeding a combined $1 million to resolve allegations of Medicaid fraud lodged by investigators for Attorney General Letitia James.
And the attorney general filed lawsuits against three other Buffalo-area transportation companies that allegedly engaged in similar scams seeking combined damages of nearly $4.2 million.
The businesses were among 25 companies statewide accused of trying to steal from Medicaid, the publicly funded health care for the poor, through illegal schemes that included the use of bogus addresses and reimbursement for medical trips that never took place, according to the AG’s Office.
Businesses, including taxi companies, that transport Medicaid patients to and from medical services, can enroll with the state as authorized eligible providers to bring Medicaid patients to various medical appointments. Companies must use licensed drivers, proper vehicles and only bill for the services they provide.
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, nonemergency, medical appointments. The companies must use licensed drivers, proper vehicles and bill Medicaid only for services actually rendered, which includes a base rate for the trip, mileage and any tolls.
The investigation, led by James’ Medicaid Fraud Control Unit, targeted companies exploiting that system.
“From Buffalo to the Bronx, we鈥檙e holding scammers accountable and returning millions of dollars in stolen funds to Medicaid, a taxpayer-funded program,” James said in a statement, promising to “go after anyone who tries to profit by undermining our health care system.鈥
The Western New York businesses that agreed to settlements, according to James’ office, included:
鈥 Lakeview Global, based in Clarence, which paid $684,308 to resolve allegations that the company “claimed trips that did not occur or used false addresses that resulted in excess payments.” An attorney for the company did not return an email seeking comment immediately.
鈥 Divine Hearts Transportation in North Tonawanda agreed to pay $227,010 to resolve allegations it overbilled for “false addresses and fictitious trips.” An attorney for the business did not return an email seeking comment.
鈥 KFH Medicaid Transportation, which had operated in Amherst and is now out of business, agreed to pay $143,760 to settle allegations the company “submitted fake rides for reimbursement from Medicaid.” An attorney for the company could not be immediately reached.
Companies in Western New York facing lawsuits from James included:
鈥 Green Cab BNY in Cheektowaga, which James’ office contends billed Medicaid for trips with falsely inflated mileage. A complaint filed in State Supreme Court in Erie County said that between Jan. 1, 2017, and March 31, 2018, the company submitted 9,233 claims in which it “attested to having picked up and/or dropped off Medicaid recipients at false addresses to inflate the mileage of the trips to receive higher payment amounts.” Green Cab’s owner, William Mills, could not be immediately reached. The attorney general seeks damages of at least $2,385,398.
鈥 Buffalo Taxi Services in Amherst, which James’ office said billed Medicaid for trips that “never actually happened.” A complaint filed in State Supreme Court in Erie County said between April 1, 2020, and Dec. 31, 2020, the company submitted 2,261 claims “for trips that they did not conduct.” The company owner, Aws Almafrachi, could not be reached. The suit seeks at least $1,691,714.
鈥 SMI Transportation in Buffalo, which James’ office said inflated mileage and used a driver who had been excluded from providing Medicaid services due to a previous conviction for Medicaid fraud. A complaint filed in State Supreme Court in Erie County said between April 4, 2018, through July 31, 2019, the company submitted false Medicaid claims and “accepted payment on those false claims, purporting to provide nonemergency transportation services to Medicaid recipients traveling to or from health care services paid for by Medicaid.” The company owner, Payam Jalal, who is also known as Shivan Mohammed, could not be reached. The suit seeks at least $96,827.