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星期四, 8月 14, 2014

OWNER OF MEDICAL TRANSPORTATION COMPANY PLEADS GUILTY TO BILLING TAXPAYERS FOR RIDES UNDER DEAD PEOPLE’S NAMES

OWNER OF MEDICAL TRANSPORTATION COMPANY PLEADS GUILTY TO BILLING TAXPAYERS FOR RIDES UNDER DEAD PEOPLE’S NAMESCross Roads Trolley in Webster Received More than $470,000 in Payments for Medical Transportation Services Never Provided
WORCESTER – The owner of a medical transportation company in Webster has pleaded guilty to defrauding the state’s Medicaid program (MassHealth) of more than $470,000 by billing for services under the names of deceased individuals, and for other medical trips that were never provided, Attorney General Martha Coakley announced today.
Cynthia J. Keegan, 51, of Webster, and her company Keegan Enterprises, LLC, d/b/a Cross Roads Trolley pleaded guilty today in Worcester Superior Court before Judge Janet Kenton-Walker on charges of Larceny over $250 (7 counts each) and Medicaid False Claims (7 counts each).
“The owner of this company intentionally stole thousands of dollars from taxpayers by billing for rides that never occurred, or for people who were deceased,” AG Coakley said. “This coverage is meant to provide transportation services for residents who need outpatient medical care, and we cannot tolerate those who take advantage of MassHealth.”
A sentencing hearing for Keegan has been set for Aug. 21 in Worcester Superior Court.
The AG’s investigation into the matter, after being referred by MassHealth, revealed that Keegan falsely billed for rides provided to more than 40 individuals after their death, and under the names of a dozen residents at two different nursing homes who never actually received rides on the claimed dates of service.
Cross Roads Trolley is a privately held wheelchair van company that provides non-emergency medical transportation services when personal transportation is not suitable due to the MassHealth member’s physical condition.
According to the AG’s Office, Keegan, over a five-year period, submitted more than 8,300 fraudulent transportation claims for 12 residents at two nursing facilities in West Brookfield, and received payments totaling more than $400,000. The AG’s investigation found that the billed services were actually for individuals that rarely left the nursing facility for medical care, or didn’t reside there on the claimed dates of service.
Keegan also submitted more than 1,500 claims to MassHealth under the names of 47 deceased MassHealth members. In one case, Keegan repeatedly billed MassHealth for transportation services more than five months after a woman’s death. Of the 1,500 false claims that were submitted, only 152 claims were actually paid out for a total of $6,900.  The rest of the claims under those names were rejected by MassHealth.
In addition, Keegan billed for rides under the names of at least four other MassHealth members who were not transported to obtain covered medical services on the claimed dates of service. These additional 1,000 false claims resulted in payments totaling nearly $70,000. 
A Worcester Grand Jury returned indictments against Keegan and Cross Roads Trolley on Sept. 19, 2013. Keegan was arraigned on Oct. 8, 2013. Cross Roads Trolley was later arraigned on Nov. 21.
Assistant Attorney General Ian R. Marinoff prosecuted this case as part of the Attorney General’s Medicaid Fraud Division. This case was investigated by Dean Bates and Robert Ames also from the AG’s Medicaid Fraud Division.

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