SEMINOLE COUNTY, Fla. — The owners of a Central Florida medical transportation company are facing allegations that they fraudulently billed the Medicaid program for more than $275,000.
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According to court records filed in Seminole County, an investigation by the State Attorney General’s Medicaid Fraud Control Unit identified 50-year-old Debora Behnke and 37-year-old Suman Bhattacharjee as the owners of Pioneer Medical Transportation LLC, which was contracted with Florida Medicaid Non-Emergency Medical Transportation providers to take Medicaid recipients to methadone treatment facilities and return them to their homes.
According to an arrest warrant for both, the couple billed the Medicaid Program with false NEMT claims between March 8, 2021, and December 31, 2022, totaling $276,377.
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The warrant says the Office of the Attorney General first received a complaint regarding Pioneer Medical Transportation on April 27, stating that company employees were “paying Medicaid patients to keep them using their services so they can charge Medicaid for the transportation.”
The complaint claimed that company employees were “pretending to be the patient or the patient’s family member” so they could make appointments to use the company’s services.
During an interview, the person who filed the complaint told investigators Behnke owned the company, while Bhattacharjee- who the report states was known to be a “part-time paramour” of Behnke’s- managed it.
The tipster told investigators Bhattacharjee would call the insurance companies, acting as either the Medicaid recipients themselves or on their behalf, to schedule transportation to and from medical appointments, but was not always completing the scheduled trips while still billing Medicaid for profit.
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Investigators say the tipster told them Bhattacharjee would then pay the actual Medicaid recipients whose trips were not completed to ensure their continued use of the company’s services. Investigators say the payments were also meant to provide the Medicaid recipients with some income in exchange for using their Medicaid information to bill the program while not actually providing the transportation.
Investigators say the tipster went on to tell them many of the Medicaid recipients Bhattacharjee was taking advantage of were victims of opioid addiction in methadone programs designed to wean them off the substances.
After a lengthy investigation employing Florida Medicaid claims and billing records, Medicaid recipient medical records, substance abuse treatment center attendance records, law enforcement reports, bank records, cell phone data, witness statements, and other evidence, the OAG concluded that Behnke and Bhattacharjee had clearly falsified documents to fraudulently bill the Medicaid Program for “services that were not rendered” and provided “kickbacks” to the actual Medicaid recipients in exchange for the fraudulent use of their Medicaid information.
Records state investigators determined they had cause to issue arrest warrants for both Behnke and Bhattacharjee. They also acquired search warrants for both of their homes in Oviedo.
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Bhattacharjee was booked into the Seminole County jail Wednesday, charged with one count of Medicaid provider fraud and one count of scheming to defraud. He has since been released on a total of $40,000 bond.
Behnke is yet to be arrested.
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