Largest $2.9M Medicaid Fraud in Orange County Comes as Healthcare Scams Grow, DA Says

Orange County District Attorney David Hoovler and New York State Comptroller Thomas DiNapoli announced in October that the county prosecuted the largest Medicaid fraud scheme ever prosecuted by the Orange County DA’s office, allegedly stealing $2.9 million in Medicaid fraud.

A couple named Rohail Raja and Sharma Alam were arrested and charged with Grand Larceny in the first degree for allegedly stealing millions from the New York State Department of Health as part of a broader Medicaid defrauding scheme. The joint investigation was conducted by the Orange County District Attorney’s Office, the Office of the New York State Comptroller, the Orange County Sheriff’s Office, and the Orange County White Collar Crimes Taskforce.

“It is a very sophisticated scheme run by two individuals that had multiple corporations that basically were taking advantage of the billing system for Medicaid,” Hoovler told Radio Catskill.

Hoovler said that the couple allegedly overbilled fraudulent transportation claims to the state, claiming they would individually pick up clients from different locations but actually picked them up from the same location. The couple would also tack on fake ‘ghost riders’ to their claims to make it appear they were providing more rides than they had completed, says Hoovler.

During the investigation, investigators found that the New York State Department of Health had paid the transportation company owners an excess of more than $2 million for Medicaid recipient rides and visits that did not occur.

“Every fraud affects the public as a whole, so these monies here that they’re basically swindling off the government is causing the government to lose money – money that could be spent in other locations, money that could be spent on the same program properly so it’s the public in general that’s losing it,” said Hoovler.

As healthcare schemes grow more frequent and sophisticated, he advises residents to stay vigilant to their online and financial activities and manage as much of their affairs in person.

“The public, first and foremost, needs to be diligent when it comes to reading your credit card statements, your bill statements, and who you’re dealing with online,” said Hoovler.

Image: Exterior of a white ambulance van (Photo Credit: Image by Alina Kuptsova from Pixabay )