“When providers bill and receive Medicaid payment by submitting claims reflecting services performed by unqualified providers and without required documentation, New York tax dollars are spent on services which are ineligible for such payment,” said Attorney General Schneiderman. “My office will continue working to investigate and address fraud alleged by whistleblowers in order to preserve the integrity of the Medicaid program and ensure that recipients receive quality services; and we will ensure that those responsible are held accountable.”
The Attorney General’s investigation determined that in 2009, after a Department of Motor Vehicles audit found that certain of the company’s drivers were unqualified under Article 19-A of the Vehicle and Traffic Law, First Call submitted and received payment on Medicaid claims for transportation services which identified such unqualified drivers as having provided the claimed services. In addition, the Attorney General found that for transportation services claimed to have been provided from June 1, 2007 through September 24, 2009, the company failed to maintain contemporaneous records demonstrating their right to receive payment in violation of Medicaid billing rules. The investigation settled False Claims Act allegations that are identified in the settlement agreement, pursuant to a qui tam lawsuit filed by whistleblower Thomas D. Ayers asserting claims under the New York False Claims Act.
As a result of the settlement, the company will pay New York State $173,650.83 in restitution and damages pursuant to the New York False Claims Act.
