Leader Of $8 Million Medicaid Fraud Scheme Sentenced To 95 Months In Prison

 

 Damian Williams, the United States Attorney for the Southern District of New York, announced that JULIO ALVARADO was sentenced to 95 months in prison for leading a sprawling scheme to defraud Medicaid of millions of dollars through the billing of fraudulent transportation claims.  ALVARADO previously pled guilty to one count of healthcare fraud.  U.S. District Judge Kimba M. Wood imposed today’s sentence.

U.S. Attorney Damian Williams said: “Julio Alvarado was the leader of a multi-million-dollar scheme to defraud Medicaid by filing false claims for medical transportation services that were never provided.  He brazenly lined his own pockets with Medicaid funds meant to help the neediest New Yorkers.  This sentence makes clear that this type of criminal conduct will be prosecuted and punished to the full extent of the law.”

According to court filings and statements made in court proceedings:

From August 2017 to February 2020, KJ Transportation C Services Inc. (“KJ”) was paid more than $20 million for providing transportation services for Medicaid enrollees in the New York City area.  A large volume of those claims were fraudulent.  In some instances, the Medicaid recipient was deceased or out of the country when KJ claimed it was transporting that person to medical appointments.  In other instances, the company used stolen identities, whereby the Medicaid recipient had never heard of KJ and had never taken any rides with the company.  In other instances, the Medicaid recipients had received unlawful kickbacks from defendants in exchange for either providing KJ their Medicaid information or for fraudulently scheduling trips they did not take.

ALVARADO, who supervised more than a dozen other participants in the scheme, was responsible for billing more than $8 million in fraudulent trip claims.

In addition to the prison term, ALVARADO, 63, of Yonkers, New York, was sentenced to three years of supervised release and ordered to pay $8,507,115 in restitution and to forfeit $8,507,115.

Mr. Williams praised the outstanding work of Homeland Security Investigations and the United States Department of Health and Human Services’ Office of Inspector General.  He also thanked the Office of the Medicaid Inspector General for its assistance.