No Free Rides

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Medicaid pays for non-emergency ambulance transportation costs as long as a doctor provides a statement justifying the need for the service. (Medicaid beneficiaries are eligible for this service if they don’t have a working vehicle or a driver’s license; have a mental or physical disability; or are unable to travel or wait for a ride by themselves.)A co-owner of a Chicago-based non-emergency medical transport company tried to hitch a free ride on the government by overbilling Illinois’ Medicaid program by $4.7 million in services her company did not provide as claimed.

For about five-and-a-half years, the woman and her male co-owner submitted bills on behalf of deceased people and others they did not actually transport. They also charged the state’s Medicaid program for dates that the patients were approved for transportation, but did not actually ride. (Fraudulent claims were submitted despite the fact that the daily route sheets documented exactly who was transported.) In addition to billing for services not rendered, the fraudster and her co-conspirator also claimed excess mileage that was not actually driven.

The 44-year-old woman pleaded guilty to her role in the scheme and was sentenced to 30 months in prison. Her 67-year-old co-conspirator was convicted of conspiracy and seven counts of mail fraud. They were both ordered to each pay $4 million in restitution.

It doesn’t look like this fraudster will be driving anyone, much less herself, for the next 30 months. Her fraudulent scheme has finally run out of gas and she will be parked behind bars for a while. (That will definitely take the air out of your tires.)

Source: Today’s ”Fraud of the Day” is based on a Department of Justice press release entitled, ”Co-owner of Chicago Medical Transport Company Sentenced for Fraudulent Billing Scheme,” released on August 17, 2016.

Springfield, Ill. – A Chicago woman who previously pled guilty to her role in a scheme to overbill Illinois’ Medicaid program has been sentenced. On Aug. 15, 2016, U.S. District Judge Sue E. Myerscough ordered Tina Kimbrough, 44, of Berwyn, Ill., to serve 30 months in federal prison. Kimbrough and Gregory D. Toran, 67, of Hazel Crest, Ill., owned IBT Transportation, LLC., a non-emergency medical transport company, during the period of the fraud conspiracy, from December 2005 to June 2011.

Toran was convicted of the conspiracy and seven counts of mail fraud following a bench trial before Judge Myerscough, who rendered her guilty verdicts in late July 2016. Kimbrough was also ordered to pay $4 million in restitution, due jointly and severally with Toran, who is scheduled to be sentenced on Nov. 14, 2016. Kimbrough is to self-report as directed by the federal Bureau of Prisons to begin serving her prison term.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.