Tag Archives: ambulette

Queens-based transportation company to pay $300K to settle overbilling allegations


By Queens Courier Staff | editorial@queenscourier.com

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BY ROSS BELSKY 

A Queens-based company has agreed to repay Medicaid $300,000 in overcharges for the transportation of mental health patients under a settlement announced Monday by Attorney General Eric Schneiderman.

Apple Transportation of New York Inc., which serves Medicaid recipients, billed the health care program unnecessarily between January 2004 and October 2008. The rides in question were for basic livery services that required no physical assistance for outpatients of mental health programs. But Apple charged Medicaid for Ambulette services, which do include physical assistance for patients and are billed at a  higher rate.

The case was investigated by Medical Fraud Control Unit Special Investigator Nancy Calo-Kenney, Auditor Investigator Kashmir Singh, and Medical Fraud Control Unit Acting Director Amy Held.

“Those who bill Medicaid for services they did not provide are stealing from taxpayers and depriving other New Yorkers of needed assistance,” Schneiderman said. “There has to be one set of rules for everyone, and my office will not allow Medicaid providers to siphon funds from the program by over-billing.”

As part of the settlement, Apple admitted “frequently” charging for the higher-priced ambulette service over the four-year period when it wasn’t necessary based on the patients’ needs, according to the attorney general’s office.

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Ambulette checks result in summonses, seizures


| ctumola@queenscourier.com

The New York State Office of the Medicaid Inspector General (OMIG) and New York City Taxi and Limousine Commission (TLC) recently conducted a surprise check of ambulette service providers in Queens and Brooklyn.

During two investigations in the last month, the OMIG and TLC issued more than 15 summonses. Violations included unlicensed drivers and vehicles, insufficient paperwork and lack of proper decals on display. All three of the unlicensed vehicles were seized.

Also known as paratransit vehicles, ambulettes are specially designed vans that transport the disabled, elderly and patients in non-emergency situations. They need to be equipped with a wheelchair lift, and drivers must be trained to help passengers in and out of the vehicle.

An increase in ambulette billings in New York City led to the inspections, said OMIG spokesperson Wanda Fischer. Though this data didn’t specifically indicate that drivers and vehicles were operating unlicensed, it prompted a check for any kind of possible abuse or fraud.

Last month, the OMIG and TLC conducted an inspection along Queens Boulevard in Forest Hills and at Elmhurst Hospital. On that day, they issued eight summonses for unlicensed drivers and an unlicensed van. The vehicles were from a variety of ambulette companies, but the OMIG would not say which companies were included in the review.

The Queens violations prompted another inspection by the OMIG and TLC in July, of the areas on and around Coney Island Avenue and Coney Island Hospital. Both the Queens and Brooklyn locations were chosen because of their proximity to hospitals, but otherwise were selected at random.

“[These checks] will hopefully serve as a warning,” said Fischer. “We are trying to get providers to improve their own internal controls and find their own mistakes and stop them before they happen.”

Canute Smith, owner of Leon’s Ambulette, located in Jamaica, said that many ambulette violations are minor and simple to fix. For example, drivers who are licensed to operate seven-passenger ambulettes, may not update their licenses when they start driving 15-passenger vehicles.

Smith, who said his company’s ambulettes and drivers are properly licensed, added that ambulette compliance checks are nothing new, but wishes that the OMIG and TLC would give notice beforehand.

The OMIG and TLC can foresee doing more reviews together in the future, said Fischer. But she cannot say when or where because the checks wouldn’t be as effective if they weren’t a surprise.