Feds Target Ambulette Fraud

After U.S. Attorney's office officials raided an ambulette company last month, the New York Post dug into Medicaid data on the services, and uncovered several ongoing state investigations and multimillion-dollar costs.

At the top of the Post's list: Abraham Demoz, a physician who runs Sunshine Medical Center in Canarsie, N.Y. The data revealed that Demoz authorized nearly 111,000 one-way trips in 2009--the latest year available--costing Medicaid $3.4 million.

These ambulette services are non-medical transport companies that charge $25 to $35 per trip to ferry Medicaid patients to and from doctor's appointments, pharmacies and the like. However, investigators suspect some of the trips authorized by Demoz and other physicians are to non-medical destinations.

But regulators aren't sitting on their hands on this one. New York health department officials told the Post that they've handed Demoz's name to the Medicaid Inspector General for further inquiry. And the MIG just last month demanded repayment of more than $430,000 from ambulette user Interline Employee Assistance Program in Jamaica, a substance-abuse clinic whose patients used $1.8 million worth of the transport services.

Source:  www.fiercehealthcare.com