Monday, March 20, 2023

Attorney General James Secures More Than $860,000 from Capital Region Medical Transportation Company for Medicaid Provider Fraud

 

Ismat Farhan and USA Medical Transport Falsely Billed Medicaid for Services His Company Did Not Provide  

 New York Attorney General Letitia James today announced a settlement with Ismat Farhan and his company, USA Medical Transport, which provides transportation to and from medical appointments for Medicaid recipients, for defrauding Medicaid. The settlement resolves the Office of the Attorney General’s (OAG) findings that Farhan submitted over 2,500 false claims and billed Medicaid for approximately $400,000 for transportation services that either did not occur as described, lacked required documentation, or never took place at all, in violation of New York False Claims Act. As a result of the settlement announced today, Farhan will pay $862,500 to the New York State Medicaid Program.  

“Medicaid is meant to help support the medical needs of vulnerable New Yorkers, not to pad a company’s profits,” said Attorney General James. “Farhan and USA Medical Transport took advantage of their patients and taxpayers by billing Medicaid for thousands of services that were never provided. My office will keep ensuring that our state’s laws are followed and that Medicaid dollars are spent helping New Yorkers in need.”  

Medicaid recipients are eligible to receive transportation to and from medical appointments with doctors or healthcare providers who are enrolled with Medicaid. Additionally, Medicaid will reimburse all enrolled transportation companies for these services. To operate as a Medicaid transportation provider, a transportation company must enroll and certify that it will follow the Medicaid program’s rules and regulations, including submitting claims only for services that actually took place and maintaining thorough records documenting those claims.   

The OAG found that between June 2015 and February 2020, Farhan, through USA Medical Transport, submitted fraudulent claims to Medicaid, including claims for:  

  •   Rides that were not provided;  
  •   Mileage amounts significantly greater than the actual ride;  
  •   Single rides that should have been bundled as a group ride;  
  •   Rides provided by drivers with suspended licenses, including Farhan himself; 
  •   Rides that lacked supporting documentation; and  
  •   Reimbursements for tolls that USA Medical Transport did not actually incur.  

The investigation was conducted by the Albany Regional Office of OAG's Medicaid Fraud Control Unit (MFCU) under the supervision of Detective Supervisor John Benshoff and Deputy Chief, Commanding Officer William Falk; and Senior Auditor-Investigator Nathaniel J. Wood, under the supervision of Regional Chief Auditor Sarah Finning. 

The settlement was handled by Special Assistant Attorneys General Emily Auletta of the MFCU Albany Regional Office and Jill D. Brennerof the MFCU Civil Enforcement Division, with the assistance of Konrad Payne, Deputy Chief of the Civil Enforcement Division. The Albany Regional Office is led by Albany Regional Director Kathleen Boland and the Civil Enforcement Division is led by Civil Enforcement Division Chief Alee N. Scott. MFCU is led by Director Amy Held and Assistant Deputy Attorney General Paul J. Mahoney and is a part of the Division for Criminal Justice. The Division for Criminal Justice is led by Chief Deputy Attorney General José Maldonado and overseen by 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) 2023 is $65,717,936. Of that total, 75 percent, or $49,288,452, is awarded under a grant from the U.S. Department of Health and Human Services. The remaining 25 percent, totaling $16,429,484 for FY 2023, is funded by New York state. Through MFCU’s recoveries in law enforcement actions, it regularly returns more to the state than it receives in state funding. 

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