Ti Taxi: The Patient Drove, Medicaid Paid the Taxi

The Ti Taxi Medicaid fraud case involved false trips and inflated mileage that the company’s owner admitted in a criminal guilty plea. Patients drove themselves to medical appointments while Ti Taxi billed Medicaid for taking them. For a driver, dispatcher or biller, the revealing detail is the false driver identity attached to that claim: someone made the paperwork describe a ride the company never supplied.

Ti Taxi Inc. was a Medicaid-funded transportation company based in Ticonderoga, New York. The Justice Department’s July 10, 2019 plea announcement described its owner’s admissions about false billing and payments to keep passengers booking with the company.

What the Owner Admitted About Ti Taxi Trips

In his guilty plea, Ti Taxi’s owner admitted defrauding Medicaid and the New York State Department of Health through three billing methods: billing for patients who drove themselves, billing round trips for one-way rides, and changing locations to increase the mileage claimed. Each method changed a different part of the journey represented to Medicaid.

The Patient Supplied the Ride

The owner admitted billing Medicaid and receiving payment when beneficiaries drove themselves to their medical appointments. He also admitted falsifying the identities of the drivers for those trips. The patient’s own journey became a paid taxi trip on paper, complete with a driver identity that did not tell the truth about who drove.

The patient drove. Ti Taxi collected. The appointment supplied the occasion for the claim. The company supplied the fiction that it had taken the patient there.

One Leg Became a Round Trip

The owner also admitted billing and receiving payment for round trips when beneficiaries took only one-way trips with Ti Taxi. Here, the company had provided some transportation. The false claim added the other leg.

The direction of travel matters to the comparison. A dispatcher may know that Ti Taxi supplied only the outward journey, while a billing employee sees a completed round trip. We want to understand how the extra leg entered the claim and who authorized billing it.

Different Locations Produced Higher Payments

The third admission concerned false pickup and drop-off locations. The owner changed those locations to increase the distance the company claimed to have traveled and obtain higher Medicaid payments.

The address fields were doing financial work. A passenger’s actual journey and the journey described for payment could have different starting points, destinations and distances. A billing employee might see the submitted locations while a driver knows where the passenger actually got in and out. Connecting those accounts is how we make the discrepancy concrete.

Cash and Goods for Repeat Bookings

The owner admitted paying kickbacks to Medicaid beneficiaries to induce them to schedule, and keep scheduling, transportation appointments with Ti Taxi. According to the plea announcement, those kickbacks included cash, phone cards, cigarettes and tobacco, and free goods at his convenience store in Ticonderoga.

The convenience store belongs in the transportation story because it supplied some of what the owner used to attract repeat business. The same owner admitted both paying for bookings and falsifying transportation claims. Passenger recruitment and billing were connected parts of the operation.

For an insider, that connection can cross job boundaries. Someone who saw what passengers were offered may understand how bookings were obtained. Someone handling those bookings may know the company and trips involved. Someone handling claims may see what Medicaid was asked to pay. We bring those accounts together around the particular passengers, trips and decisions they describe.

The Essex County Investigation

The May 23, 2018 charging announcement described the arrests of thirteen people in a federal and state investigation of medical transportation operators based in Essex County. It listed federal kickback charges against Ti Taxi’s owner. His state charges included theft, falsifying business records and failing to secure workers’ compensation coverage.

The plea announcement identified the FBI and the New York State Police’s Special Investigations Unit as investigators of the federal charges. State Police and the Office of the New York State Inspector General investigated parallel state charges.

What Evidence Is Needed to Prove Fraud?

For false transportation billing, the useful evidence connects what happened on the road to what the company claimed, what Medicaid paid and who knew the difference. The owner’s admissions give that comparison a precise shape: the passenger who drove, the driver identity entered, the leg actually supplied and the locations used to claim mileage.

Medicaid can cover travel to and from medical appointments when a beneficiary lacks other suitable transportation. In this case, the owner admitted receiving payment both for rides the company had not supplied and for inflated descriptions of rides it had supplied.

The payment arrangement also determines whose records matter. Transportation providers may receive payment directly from the state or through a broker. In a brokered transportation operation, we examine the handoff between the company describing the trip and the organization processing that account for payment.

Dispatch assignments, driver records, pickup and drop-off information, and the billed trip answer different questions. We compare them with the passenger’s account and the payment record. Your knowledge may explain who changed a location, why a return trip appeared, or why the named driver could not have supplied the ride. That is the inside account we want to understand with you.

The 1999 federally sponsored seminar report Controlling Fraud and Abuse in Medicaid: Innovations and Obstacles described Texas analysts grouping claims for the same patient and day to spot duplicates and incompatible services. For a transportation inquiry, we ask how the claimed journey fits the care recorded for that passenger.

No Requirement to Check With the Passenger

In its December 2014 Georgia Comprehensive Program Integrity Review, the Centers for Medicare & Medicaid Services found that one transportation broker performed no proactive analysis for unusual billing or suspected fraud. The review of Georgia’s transportation controls also identified a particularly revealing gap:

We expect the person supposedly transported to have a place in checking a transportation claim. The Georgia finding shows why that expectation matters: a review confined to the company’s version of the journey can leave the passenger’s version unheard.

The same report described another broker’s use of driver tablets to record locations, time stamps and electronic signatures. Those records could show a vehicle’s distance from the designated pickup point or a provider claiming to be in different places at the same time. An independently recorded location, a driver’s identity and a passenger’s account can test the trip described on the claim.

False-Trip Billing Beyond Ti Taxi

An Illinois transportation-company owner agreed to a $346,648 civil settlement over allegations of fraudulent billing for one-day trips, according to the HHS Office of Inspector General’s Medicaid Fraud Control Units Fiscal Year 2014 Annual Report. The Illinois Medicaid Fraud Control Unit entered into that settlement.

False transportation billing appears in civil settlements as well as criminal pleas. The Illinois settlement resolved allegations against a transportation-company owner. The Ti Taxi owner admitted inventing or inflating the service billed.

Can You Get Paid for Reporting Medicaid Fraud?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. We build the case for recovering those payments with you, with your potential whistleblower reward part of that work from the start.

You Know Who Actually Drove

If you know the driver identity, return trip or mileage on a Medicaid claim was invented, talk with our whistleblower experts about the trip behind the bill. We build your case with you, bring in Medicaid transportation whistleblower lawyers who understand false-trip billing and patient kickbacks, and remain your partners as the case develops.