The Office of the Medicaid Inspector General (OMIG) and the New York City Taxi and Limousine Commission (TLC) executed a field operation yesterday which identified unqualified drivers operating medical transportation vehicles within the Far Rockaway section of Queens. They also identified potential fraudulent activities where drivers were operating vans without a license, ambulettes in operation despite not having the proper credentials, and passenger safety issues due to driver distractions.

In the collaborative action, six investigators from OMIG and 12 inspectors from TLC conducted the coordinated review of ambulette service providers in Queens, focusing on pick-ups and drop-offs at St. John Episcopal Hospital. 

The activities yielded:

• Fifty-two stops
• Seizure of four vans
• 18 summonses issued for infractions ranging from no driver’s license to no van license to no hands-free device while using a cell phone, totaling $11,450 in fines

All stops were made at the time of pick-up or drop-off, and OMIG investigators verified that all passengers involved were Medicaid consumers. In the case of Medicaid consumers exiting the medical facilities and entering paratransit vans, the consumers indicated what services they had received while at the hospital, which demonstrated whether or not there had been medical necessity for the ambulette trip.

“This type of unannounced action is the equivalent of a ‘Stop DWI’ initiative on the part of local law enforcement agencies,” said Medicaid Inspector General James C. Cox.  “It protects other drivers and pedestrians by enhancing the safety of Medicaid consumers who use such transportation to help them obtain needed medical services.”

Allowing untrained drivers to operate vehicles that may not be properly licensed or credentialed, Cox adds, translates into “services that can potentially risk the lives of pedestrians, motorists and patients, all the while ripping off taxpayers.  The streets of New York are safer today, thanks to this operation.”

“The integrity of paratransit operators and drivers is central to the safety of this city’s most at-risk passengers,” said TLC Commissioner and Chair David Yassky.  “I’m pleased that the vast majority of operators tested in yesterday’s joint OMIG/TLC enforcement initiative were found to be compliant, but partnering on such operations sends a strong and clear message to fraudulent ambulette operators that we will find them, summons them, take their vehicles, and put them out of business.”

Five representatives from the federal Centers for Medicare and Medicaid Services also were on hand for today’s operation as observers of OMIG investigators in action.

“Law enforcement is critical to protecting older New Yorkers,” said AARP New York State Director Beth Finkel. ”AARP commends Medicaid Inspector General Cox for cracking down on untrained ambulette drivers and unlicensed vehicles as part of a scheme that puts older New Yorkers’ lives at risk while potentially inflating the cost of such an important program.”

"It's critical that licensed professionals operate dangerous vehicles like medical vans and ambulettes. Larger vehicles like these pose a greater risk to pedestrians and bicyclists and therefore require greater care to drive safely. Allowing unlicensed drivers behind the wheel poses an unacceptable and avoidable risk to New Yorkers," said Paul Steely White, Executive Director of Transportation Alternatives.

These actions are part of a multi-year effort to police Medicaid transportation.  OMIG and the TLC first conducted a pilot program on June 12, 2012, along Queens Boulevard in Forest Hills and at Elmhurst Hospital in Elmhurst. That project resulted in the issuance of eight  summonses for unlicensed drivers, an unlicensed van, and the seizure of a van for operating in New York City without the proper license.

Based on information provided by OMIG from the June 12 operation, TLC learned that some ambulette companies may have used tactics that do not comply with Medicaid rules and regulations, including subcontracting vehicles and drivers.  TLC investigators used that information during an independent transportation surveillance at a metropolitan hospital, which led to the seizure of six more ambulettes from a company that had committed a variety of infractions. 

On July 10, 2012, another joint operation in the Coney Island section of Brooklyn yielded four unlicensed or unqualified drivers, two seized vehicles, ten summonses for improper decals or documentation, and $7,600 in fines for the owners of the transportation companies.

“Fighting fraud saves lives and taxpayer dollars,” said Cox. “We are committed to working with partners like TLC to accomplish these goals.  New Yorkers can depend on it.” OMIG and TLC will continue to collaborate on further investigations to determine if Medicaid had been overcharged for services based on evidence gathered.

Medicaid Inspector General Cox thanked Commissioner Yassky and his staff for their efforts to make this another successful action. He also thanked Deputy Medicaid Inspector General Anna Coschignano and her staff for their diligence in pursuing this investigation. New Yorkers can assist the Office of the Medicaid Inspector General in fighting fraud, waste, and abuse by reporting potentially suspicious behavior or incidents.  OMIG encourages anyone who observes instances of potential Medicaid fraud, waste, or abuse to contact OMIG’s fraud hotline at 1-877-87-FRAUD or visit the Web site at www.omig.ny.gov. Tips can be completely anonymous, and OMIG investigates information from all calls.

-30-

Our mission is to enhance the integrity of the New York State Medicaid program by preventing and detecting fraudulent, abusive, and wasteful practices in the Medicaid program and recovering improperly expended Medicaid funds while promoting high-quality patient care.

#NYFightsFraud.