State Sen. George Borrello, R-Sunset Bay, and County Executive PJ Wendel talk following a news conference in June. Borrello is calling again for non-emergency medical transportation dispatch responsibilities to be returned to counties after two fraud cases totaling $3.4 million were announced last week by Attorney General Letitia James.
The alleged theft of $3.4 million in Medicaid fraud by transportation companies in Central New York is prompting the region’s state senator to renew calls to reform the Non-Emergency Medical Transportation system.
The Non-Emergency Medical Transportation program allows Medicaid recipients who lack access to transportation to use approved transportation providers to travel to and from covered medical services. Providers receive reimbursements from Medicaid for the rides they provide.
State Sen. George Borrello, R-Sunset Bay, has pushed for reforms to the system for the past several years, including working to reform the program during negotiations on the state’s 2020-21 budget. Those reforms included changes to incentivize brokers to operate more efficiently and cost-effectively, encourage greater use of public transportation providers, creation of new quality control standards and reduced rates for taxi NEMT services by 7.5%.
Despite the reforms Borrello has railed against the program in recent years, calling for a return to county-based dispatch of non-emergency transports because the brokers used by the state have too often stolen money.
“It’s about time,” Borrello said when contacted for comment by The Post-Journal and OBSERVER. “This program should have been discontinued and the dispatch of these non-emergency Medicaid trips should return to the counties like it was originally. It was pay-to-play corruption that started by disgraced Gov. Andrew Cuomo that created this fraudulent transportation broker system.”
Last week, Letitia James, state attorney general, recently announced charges in two separate cases alleging companies bilked state taxpayers out of millions of dollars. The state Attorney General’s office has indicted Daler Yuldashev and Damir Yuldashev, their company DYD Universe Inc. (DYD), and Nigina Iskandarova for their roles in a scheme that allegedly stole more than $2.3 million from Medicaid and paid illegal kickbacks to Medicaid recipients. The Yuldashevs allegedly operated DYD as a medical transportation provider and used it to overcharge Medicaid millions of dollars in fees by billing for fake trips and adding fake tolls to the rides they did provide. Along with Iskandarova, they also illegally paid kickbacks to Medicaid recipients to recruit more customers.
From April 2018 to March 2023, Daler and Damir Yuldashev billed Medicaid for fictitious trips and added fake tolls to their trips to inflate their costs. DYD’s claims often added toll charges of $15 to as much as $50 when the journey did not incur any toll at all. As a result of their scheme, DYD allegedly illegally overcharged Medicaid over $2.3 million.
Daler and Damir Yuldashev, who were arrested on July 2, were charged with Grand Larceny in the First Degree, two counts of Health Care Fraud in the Second Degree, five counts of Medical Assistance Provider Prohibited Practices, and six counts of Offering a False Instrument for Filing in the First Degree. Nigina Iskandarova was also arrested on July 2 and charged with four counts of Medical Assistance Provider Prohibited Practices. The Grand Larceny charge carries a maximum sentence of up to 25 years in state prison and the kickback charges against Iskandarova carry a maximum sentence of up to four years in state prison.
In a separate case, James announced charges against David Moore of Tompkins County, who through his company ASAP 2, allegedly stole more than $1 million from Medicaid by using fictitious billing and an illegal kickback scheme to overcharge for transportation services. For years, Moore illegally paid Medicaid recipients to use his company, and then fraudulently overcharged Medicaid for the rides he provided.
From January 2019 to August 2023, Moore allegedly paid Medicaid recipients to use his service, submitted claims for fictitious trips, and significantly inflated the mileage of trips that did happen to overcharge Medicaid by over $1 million. For example, Moore submitted claims for fictitious trips by allegedly billing trips with multiple passengers as if each passenger was in a separate vehicle, greatly increasing the fees for a single trip.
Moore also allegedly paid kickbacks to Medicaid patients to use his services. This allowed him to illegally recruit customers in order to fraudulently bill Medicaid for more rides, and undermined the businesses of other transportation providers in the Southern Tier. Moore made off-the-books payments to Medicaid recipients – some of whom were suffering from substance use disorder – using Cash App and Venmo to incentivize them to take rides with his service.
Borrello initially was moved to take action when Chautauqua County’s costs for non-emergency medical transportation increased 1,300% between 2013 and 2019. The primary factor driving the increased spending was a sharp rise in single-rider taxi service in lieu of public transportation, following the state’s takeover of NEMT coordination from the counties. Brokers under this system were reimbursed on a fee-for-service model that incentivized volume rather than efficiency.
Over the past four years Borrello has frequently brought up the non-emergency medical transportation program as a source of fraud and wasted money.
“The Medicaid Redesign Team identified this as a problem four years ago, as did state Comptroller Tom DiNapoli, and myself,” Borrello said Monday. “All of us referred to this program as filled with waste, fraud and abuse. Yet Governor Hochul has not acted to correct it. One can only assume it’s because the same campaign donors that provide the broker service under Andrew Cuomo are now supporting Governor Hochul and her allies.”