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Service Coordination

Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

This scheme is brought to you by three Philadelphia-based service coordination agencies: Brighter Care Services, Pennsylvania Service Coordination Agency, and Pennsylvania Development Agency. Service coordination is a specialized care management service that involves multiple agencies or organizations working together to achieve a common goal. And in this case, the goal was fraud.

Between 2017 and 2019, these service coordination agencies fraudulently billed and received over $9 million from Medicaid. Supposedly for reimbursement for services provided by Rides Your Way, a non-emergency medical transportation (NEMT) company. NEMT covers all transportation services provided to patients not in an emergency situation or in need of an ambulance. For instance, a drive to the pharmacy or a doctor’s appointment. Not surprising that fraudsters also use NEMT services too. For their schemes. Rides Your Way supposedly provided a total of 1,712 rides to Medicaid consumers. But at the cost to the taxpayer of $9 million, things didn’t add up. Turns out, Rides Your Way was driving to the hospital gift shop. And possibly the Target next door to the pharmacy. Or maybe not driving at all. And most of the Medicaid participants enrolled with Rides Your Way never used the service.

On May 9, 2024, Jason Alexandre, Rex Barr, Earlson Satine, and Natasha Hudson pled guilty to Medicaid fraud. Alexandre, owner of Brighter Care, was sentenced to one to three years in prison. Satine was sentenced to 1½ to 5 years in prison. Hudson received 11 ½ months under house arrest. Barr has yet to be sentenced. Full restitution has been orders from all four fraudsters.

Great job by the Pennsylvania Department of Human Services with this case.

Today’s Fraud of The Day is based on “Four Convicted in $9M Medicaid Fraud Scheme” published by Franklin County free Press on May 9, 2024.

Four individuals involved in a Medicaid fraud scheme that nearly cost the program $9 million have pleaded guilty and received sentences. The conspiracy centered around overbilling Medicaid for underused and unnecessary non-medical transportation services provided by Rides Your Way and three Philadelphia-based service coordination agencies: Brighter Care Services, Pennsylvania Service Coordination Agency, and Pennsylvania Development Agency.

The participants, Jason Alexandre, Rex Barr, Earlson Satine, and Natasha Hudson, were charged with Medicaid fraud, theft by deception, and related offenses in 2021. Alexandre, owner of Brighter Care, received a prison sentence of one to three years, along with seven years of probation and was ordered to pay $1.63 million in restitution. Barr, who owned Rides Your Way, was sentenced to five years of probation and 100 hours of community service, in addition to repaying $3 million.

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