Pennsylvania Attorney General Josh Shapiro on Tuesday charged four Philadelphia business owners in a $10 million Medicaid fraud.
Three agencies that were supposed to coordinate home and community services for Medicaid beneficiaries conspired with a nonmedical transportation company to overbill for services between 2017 and 2019, the state’s top prosecutor alleged.
“Criminals who defraud Medicaid are stealing from our most vulnerable Pennsylvanians,” Shapiro said. “My office will not allow a few bad actors to undermine the value that this program brings to families across the commonwealth.”
The alleged fraud involved a program called Community Health Choices, which includes transportation services designed to help the elderly and disabled remain in their homes.
The owners of three service coordination agencies — Brighter Care Services LLC, Pennsylvania Service Coordination Agency, and Pennsylvania Development Agency — allegedly billed Medicaid for nearly $7.9 million in nonmedical transportation services that were never provided to their clients.
Those business owners, Jason Alexandre, Earlson Satine, and Natasha Hudson, then allegedly split the profits with Rex Barr, the owner of Rides Your Way LLC, which was supposedly providing the rides under expensive subscription plans, according to the criminal complaint.
From 2017 to 2019, the three service coordination agencies billed $7.9 million for 1,712 trips with Rides Your Way, the complaint says. That works out to an average cost of $4,614 per ride. If billed at the authorized rate of $35 per ride, the total cost would have been $59,920.
Brighter Care Services and Pennsylvania Service Coordination Agency defrauded Medicaid of an additional $2 million by charging for far more services than they could possibly provide, the complaint alleges.
The four companies are based in Germantown. Two of them share the same address. The owners used a series of interconnected companies to conceal the proceeds of the fraud, the complaint alleges.
The defendants, who turned themselves in Tuesday, were charged with Medicaid fraud, theft by deception, criminal conspiracy, and tampering with public records, the Attorney General’s Office said.
Attorneys for Barr at Greenberg Traurig LLP emailed a statement: “Mr. Barr is a lifelong Philadelphia resident and remains committed to serving his community by creating jobs, mentoring current and aspiring minority entrepreneurs, and providing resources for those in need. We are in the early stage of this case and will review the Pennsylvania Office of the Attorney General’s charges and respond to them at the appropriate time.”
Attorneys for the other defendants could not be reached for comment.
The investigation began in early 2019 when the Pennsylvania Department of Human Services told the Attorney General’s Office that Brighter Care was billing for services without proper documentation and for services that weren’t provided. Later that year, Pennsylvania Health & Wellness, which manages Medicaid benefits covering long-term services, made the same complaint about Pennsylvania Service Coordination Agency.