Quantcast

Firm with Evanston tie named in $6.7M Medicaid fraud suit

capitol-low-angle

SPRINGFIELD — Illinois and federal authorities are seeking millions of dollars from a company with an Evanston address that allegedly filed nearly 60,000 false Medicaid claims since late 2004.

By Jayette Bolinski

SPRINGFIELD — Illinois and federal authorities are seeking millions of dollars from a company with an Evanston address that allegedly filed nearly 60,000 false Medicaid claims since late 2004.

Authorities say Universal Transportation II LLC, which does business as Med Star Medicar, is liable for $6.7 million, which includes the loss from the false claims, as well as damages and penalties.

Representatives of Universal Transportation could not be reached Friday. A phone number listed on the Internet is out of order, and no website could be found for the company, which has an Evanston address, according to court documents. It has not responded to the lawsuit, so it is unclear if it has an attorney.

Some online listings provide an address of 2201 Main St. in Evanston for the company, but Illinois Secretary of State onine records show the company as being headquartered in Northbrook.

The complaint originally was filed in August in U.S. District Court in Springfield. On May 9, U.S. Magistrate Judge Byron Cudmore entered a default order against Universal after it failed to respond to the lawsuit.

Universal provides non-emergency transportation of indigent Medicaid patients to doctors' visits, medical treatments and other needs covered under Medicaid.

According to the complaint, Universal Transportation, starting in late November 2004, filed duplicate claims for the same services, filed claims for services they did not provide and submitted claims for excessive mileage. Some specific examples of fraudulent claims include:

In July 2008, Universal allegedly submitted a claim for transporting a patient in November 2007. The Illinois Department of Healthcare and Family Services reimbursed Universal through Medicaid for $22.20, and Universal submitted a duplicate claim July 29, which also was paid.

In August 2008, Universal allegedly took four patients on the same date in the same vehicle to the same location and billed mileage for each patient individually, even though guidelines state Medicaid will reimburse only for the first patient in such a scenario. Universal was overpaid $73.14 for that trip.

In October 2006, Universal allegedly claimed it took a patient to a location and billed for the transportation costs. However, investigators determined the patient was in the hospital at the time and could not have been transported by Universal.

Universal submitted 6,294 claims for services it already was reimbursed for, was paid $11,420 for excessive mileage, and filed 52,763 claims for transporting people to medical treatment that never occurred, according to the complaint.

In all, the company allegedly submitted 58,956 false claims, resulting in a loss of $1.65 million.

Authorities say Medicaid is entitled to three times that, totaling $4.96 million, and they are seeking an additional $1.72 million in penalties.

The Illinois Attorney General's Office, which brought the lawsuit in conjunction with the federal government, was unable to comment Friday.

State Sen. Sam McCann, R-Carlinville, a proponent of Medicaid reform, said he was unaware of the complaint involving Universal Transportation, but he said the case suggests the Legislature should rely more on internal government watchdogs to monitor for fraud and abuse.

With government health-care spending on the rise nationally, preventing fraud and misspending should be a priority, he said.

"I think there are a lot of safeguards we could put in place if we really try," he said. "I think the government not being a good steward of taxpayer dollars has been a problem for a long time."

According to the Illinois Office of Inspector General's 2010 report for the Illinois Department of Healthcare and Family Services — the most recent report available — Medicaid fraud involving "non-emergency transportation" providers like Universal Transportation is common.

In 2010, the inspector general documented four such cases involving a total of $1.71 million in fraudulent claims.

Statehouse New reporter Anthony Brino contributed to this report.

Reporter Jayette Bolinski can be reached at [email protected]

Editors’ Picks