Leader Of $8 Million Medicaid Fraud Scheme Sentenced To 95 Months In Prison

Press Release Leader Of $8 Million Medicaid Fraud Scheme Sentenced To 95 Months In Prison Wednesday, March 29, 2023 Share FacebookLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. XLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. LinkedInLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. Email For Immediate Release U.S. Attorney's Office, Southern District of New York Damian Williams, the United States Attorney for the Southern District of New York, announced that JULIO ALVARADO was sentenced to 95 months in prison for leading a sprawling scheme to defraud Medicaid of millions of dollars through the billing of fraudulent transportation claims. ALVARADO previously pled guilty to one count of healthcare fraud. U.S. District Judge Kimba M. Wood imposed today’s sentence. U.S. Attorney Damian Williams said: “Julio Alvarado was the leader of a multi-million-dollar scheme to defraud Medicaid by filing false claims for medical transportation services that were never provided. He brazenly lined his own pockets with Medicaid funds meant to help the neediest New Yorkers. Today’s sentence makes clear that this type of criminal conduct will be prosecuted and punished to the full extent of the law.” According to court filings and statements made in court proceedings: From August 2017 to February 2020, KJ Transportation C Services Inc. (“KJ”) was paid more than $20 million for providing transportation services for Medicaid enrollees in the New York City area. A large volume of those claims were fraudulent. In some instances, the Medicaid recipient was deceased or out of the country when KJ claimed it was transporting that person to medical appointments. In other instances, the company used stolen identities, whereby the Medicaid recipient had never heard of KJ and had never taken any rides with the company. In other instances, the Medicaid recipients had received unlawful kickbacks from defendants in exchange for either providing KJ their Medicaid information or for fraudulently scheduling trips they did not take. ALVARADO, who supervised more than a dozen other participants in the scheme, was responsible for billing more than $8 million in fraudulent trip claims. * * * In addition to the prison term, ALVARADO, 63, of Yonkers, New York, was sentenced to three years of supervised release and ordered to pay $8,507,115 in restitution and to forfeit $8,507,115. Mr. Williams praised the outstanding work of Homeland Security Investigations and the United States Department of Health and Human Services’ Office of Inspector General. He also thanked the Office of the Medicaid Inspector General for its assistance. This case is being handled by the Office’s General Crimes Unit. Assistant U.S. Attorneys Kedar S. Bhatia and Brandon D. Harper are in charge of the prosecution. Contact Nicholas Biase (212) 637-2600 Updated March 29, 2023 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 23-117

Press Release Leader Of $8 Million Medicaid Fraud Scheme Sentenced To 95 Months In Prison Wednesday, March 29, 2023 Share FacebookLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. XLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. LinkedInLinks to other government and non-government sites will typically appear with the “external link” icon to indicate that you are leaving the Department of Justice website when you click the link. Email For Immediate Release U.S. Attorney's Office, Southern District of New York Damian Williams, the United States Attorney for the Southern District of New York, announced that JULIO ALVARADO was sentenced to 95 months in prison for leading a sprawling scheme to defraud Medicaid of millions of dollars through the billing of fraudulent transportation claims. ALVARADO previously pled guilty to one count of healthcare fraud. U.S. District Judge Kimba M. Wood imposed today’s sentence. U.S. Attorney Damian Williams said: “Julio Alvarado was the leader of a multi-million-dollar scheme to defraud Medicaid by filing false claims for medical transportation services that were never provided. He brazenly lined his own pockets with Medicaid funds meant to help the neediest New Yorkers. Today’s sentence makes clear that this type of criminal conduct will be prosecuted and punished to the full extent of the law.” According to court filings and statements made in court proceedings: From August 2017 to February 2020, KJ Transportation C Services Inc. (“KJ”) was paid more than $20 million for providing transportation services for Medicaid enrollees in the New York City area. A large volume of those claims were fraudulent. In some instances, the Medicaid recipient was deceased or out of the country when KJ claimed it was transporting that person to medical appointments. In other instances, the company used stolen identities, whereby the Medicaid recipient had never heard of KJ and had never taken any rides with the company. In other instances, the Medicaid recipients had received unlawful kickbacks from defendants in exchange for either providing KJ their Medicaid information or for fraudulently scheduling trips they did not take. ALVARADO, who supervised more than a dozen other participants in the scheme, was responsible for billing more than $8 million in fraudulent trip claims. * * * In addition to the prison term, ALVARADO, 63, of Yonkers, New York, was sentenced to three years of supervised release and ordered to pay $8,507,115 in restitution and to forfeit $8,507,115. Mr. Williams praised the outstanding work of Homeland Security Investigations and the United States Department of Health and Human Services’ Office of Inspector General. He also thanked the Office of the Medicaid Inspector General for its assistance. This case is being handled by the Office’s General Crimes Unit. Assistant U.S. Attorneys Kedar S. Bhatia and Brandon D. Harper are in charge of the prosecution. Contact Nicholas Biase (212) 637-2600 Updated March 29, 2023 Topic Healthcare Fraud Component USAO - New York, Southern Press Release Number: 23-117