LIVE OAK — A local business owner and one of his employees were arrested Monday as part of a statewide Medicaid fraud sweep.
James Daniels, the 59-year-old owner of D’s Healthcare Transportation Services, and 63-year-old Laverne Johnson, were two of the 19 individuals arrested by the attorney general’s Medicaid Fraud Control Unit and local law enforcement agencies, including the Suwannee County Sheriff’s Office, stemming from 14 cases that included fraudulent billings of more than $1 million.
“Fraud of any kind will not be tolerated in Florida,” Attorney General Ashley Moody said in a release. “It is sickening to read these stories about how individuals will use and abuse those under their care. This kind of fraud and abuse not only hurts the direct victims, but it also drives up medical costs for everyone.”
Daniels, of Jasper, was charged with organized fraud and fraudulent use of personal identification of an individual under the age of 18. Johnson, who is from Live Oak and handled the day-to-day business at the company’s Live Oak office, was charged with principal to organized fraud.
Those charges stem from the MFCU investigation into the business that revealed submission of false transportation services bills to Medicaid for trips that didn’t take place, including dates that the facility was closed due to holidays, closed due to the threat of a hurricane, and when recipients were in the hospital or, in one case, after the recipient was deceased.
According to court documents, the investigation into D’s Healthcare Transportation Services reviewed trips provided to Medicaid eligible children who were attending a Prescribed Pediatric Extended Care facility in Tallahassee.
The documents state that the company’s drivers kept transportation logs of their trips and the facility also kept a log for children that were signed in and out.
One former driver for the company told investigators that he had been told by Johnson to sign the log even when a recipient did not get on the bus, the documents state.
The investigation showed that the business had billed Medicaid for transporting children to the facility on days the facility was closed between July 4, 2016, and Nov. 23, 2017, in observance of a holiday in the amount of $9,316.60. The facility is closed for six holidays which include Christmas, New Year’s, Memorial Day, Independence Day, Labor Day and Thanksgiving.
The facility was also closed — as were schools in Leon County — from Sept. 2-6, 2016, due to Hurricane Hermine, according to the documents, which included that there were no PPEC attendance logs for that time period.
The documents state that the company billed a total of $1,160 for trips to the facility during that time.
The investigation also showed that the company billed Medicaid for trips for seven different individuals at the same time the individual was in the hospital for a total of 113 claims from Sept. 21, 2016, to June 8, 2018, in the amount of $13,770.80.
The documents state that another child moved to Jacksonville from Tallahassee in May 2017 but the company continued to bill trips for the child to the facility from June 1-12 in the amount of $2,933.
According to the documents, the company also billed for trips from Feb. 16, 2017, to April 3, 2017, in the amount of $3,564 for a child that died Feb. 15, 2017.
In all, the total loss from the falsified trips was $30,744.40.