GOSHEN – A New Windsor couple has been accused of stealing $2.9 million from the state’s Medicaid program by submitting false bills for transporting patients.
Rohail Raja and his wife, Sharma Alam, both 45 and of New Windsor, were arrested following a joint investigation by the New York State Comptroller’s office, the Orange County District Attorney’s office, the Orange County Sheriff’s office and the Orange County White Collar Crimes Task Force, assisted by the state Office of the Medicaid Inspector General and the Hudson Valley Crime Analysis Center.
Orange County District Attorney David Hoovler said this is the largest Medicaid fraud scheme ever prosecuted by his office.
Raja and Alam were arraigned in City of Newburgh Court on a felony complaint which alleges that between Feb. 1, 2020 and Aug. 30, 2024, they stole more than $2.9 million in Medicaid funds from the New York State Department of Health.
The thefts are alleged to have occurred through fraudulent claims submitted by two Medicaid transportation companies owned by the defendants. The complaint alleges that the two acted in concert with each other through two fraudulent billing schemes.
Claims for payments submitted by the defendants’ companies were compared to records from the Medicaid medical service providers named in the claims.
An auditor of the state comptroller’s office discovered that the state health department had paid in excess of $2,008,000 for transporting Medicaid recipients to Medicaid health care providers on dates and times when the provider’s records show that no such visits occurred.
In addition, a review of claims submitted by the defendants’ companies showed that they had been submitting claims to the state health department which falsely indicated that the companies had transported Medicaid recipients separately to medical appointments when in fact they had transported multiple patients in one trip.
For those trips, they were paid $895,000 more than they were entitled to.
Following their arraignment in Newburgh City Court, Raja and Alam were sent to Orange County Jail, where they are being held in lieu of $1 million cash bail, a $5 million partially secured bond or a $10 million unsecured bond each. They are scheduled to appear in Town of New Windsor Court on Nov. 5.
The names of their attorneys were not immediately available.
Hoovler said the investigation into this case is continuing, and anyone with information should contact his office at 845-291-2050.
Mike Randall covers breaking news for the Times Herald-Record and the Poughkeepsie Journal. Reach him at mrandall@th-record.com.
This article originally appeared on Times Herald-Record: New Windsor couple accused of stealing $2.9 million from New York state’s Medicaid program
Reporting by Mike Randall, Middletown Times Herald- Record / Times Herald-Record
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