Oregon DOJ convicts multiple business owners of Medicaid fraud
BEND, Ore. (KTVZ) -- Oregon Attorney General Dan Rayfield announced a series of Medicaid fraud enforcement actions from the Oregon Department of Justice's Medicaid Fraud Control Unit (MFCU), involving non-emergency transportation companies and a mental health care provider.
The cases include guilty pleas from the transportation business owners and a grand jury indictment against the mental health provider.
The enforcement actions follow investigations by the MFCU into billing for services that were never provided, identity theft and claims for transportation services for individuals who were deceased.
“Our investigation found that Medicaid patients had their identities stolen and in two of these cases, providers billed for rides given to people who had already died,” Rayfield said. “Medicaid exists so people can get care they couldn't otherwise afford. Every dollar stolen from that program is a dollar that never reaches someone who needs it.”
Among those convicted is 36-year-old Abraham Kindane Kashay of Portland, the owner and driver for Pride Transit, LLC. Referred to state investigators by Trillium Community Health Plan, Kashay submitted claims for non-emergency medical transportation services purportedly provided to a deceased person.
On Sept. 10, Kashay pleaded guilty to two counts of making a false claim for health care payment. A judge sentenced him to 36 months of supervised probation and 150 hours of community service and ordered him to pay $6,420 in restitution and a $5,000 fine. Kashay is barred from operating any business that receives Medicaid funding.
In a separate transportation case, 43-year-old Tedros Gebrezgabhere of Portland, owner and driver for Hope Medical Transport LLC, was also sentenced after a referral from Trillium Community Health Plan.
Investigators found Gebrezgabhere submitted claims for rides purportedly given to two deceased individuals. On Sept. 15, he pleaded guilty to one count of making a false claim for health care payment and one count of first-degree theft. Gebrezgabhere was sentenced to 36 months of supervised probation and 200 hours of community service, ordered to pay $12,695.34 in restitution and a $5,000 fine and barred from operating Medicaid-funded businesses.
State authorities also brought criminal charges against 28-year-old Khayre Shine of Las Vegas, Nev., and his business, Together Loving Matters LLC, following a referral from CareOregon.
A Multnomah County grand jury indicted Shine and the mental health care company on July 20 on charges of making a false claim for health care payments, aggravated first-degree theft and aggravated identity theft. Prosecutors accused Shine and the company of stealing the identities of 177 Medicaid clients and three Oregon mental health practitioners to falsely bill the state program for thousands of therapy sessions that never occurred.
