Press Release  Newton Transportation Company Resolves Claims of Improperly Billing MassHealth for Wheelchair Van Rides

Boston — A Newton transportation company and its owner will pay more than $27,000 and will be permanently excluded from being MassHealth providers to resolve allegations of improperly billing the state’s Medicaid Program (MassHealth) for wheelchair van rides when it actually was using ride share services, Attorney General Maura Healey announced today.

Under the terms of a settlement agreement with the AG’s Office, Universal Sequence Inc. d/b/a Health Line Transport, Inc., and its owner, Richard Peisch, will pay $27,589 to resolve allegations of numerous violations of MassHealth regulations from January 2014 through January 2017.

The AG’s Office alleged that Health Line and Peisch were submitting reimbursement claims for medically necessary wheelchair van transportation services for MassHealth members, while the members were allegedly transported by ride share companies like Uber and Lyft. In addition, Health Line is alleged to have submitted claims for transportation services while the MassHealth member was at an inpatient facility on the date of the claimed ride.

MassHealth provides non-emergency transportation services to aid its members in traveling to obtain covered medical services when public or personal transportation is not available or not suitable due to the member’s physical condition and circumstances. Pursuant to its regulations, MassHealth only pays transportation providers for non-emergency wheelchair van services provided to members who: (1) use wheelchairs; (2) need to be carried up or down stairs or require the assistance of two persons; or (3) have severe mobility handicaps that prevent them from using public transportation, dial-a-ride, or taxi transportation.

The AG’s Office has been active in holding medical transportation companies accountable. In November, Michael Davini, the owner of Rite Way Transportation company, was sentenced to jail after pleading guilty to charges in connection with a scheme to steal millions from MassHealth by way of kickbacks and billing for services not rendered.

This matter was handled by Assistant Attorney General Ali Russo, Senior Healthcare Fraud Investigators Robert Ames and Aleksandra Andriyevskaya, and Investigations Supervisor Dean Bates, with assistance from MassHealth and the Massachusetts State Police. The Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the Massachusetts Attorney General’s Office.

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