Springfield, Ill. – U.S. District Judge Sue E. Myerscough has rendered verdicts of guilty on all counts against a Chicago man for fraudulent overbilling of an estimated $4.7 million to Illinois’ Medicaid program for non-emergency medical transport. Sentencing for Gregory D. Toran, 67, of Hazel Crest, Ill., is scheduled on Nov. 14, 2016.
Toran owned IBT Transportation, LLC., with Tina Kimbrough, 44, of Berwyn, Ill. In June 2015, Kimbrough pled guilty to participating in the conspiracy with Toran, one count of mail fraud and one count of making false statements. Kimbrough’s sentencing is scheduled on Aug. 15, 2016.
Over 12 days, beginning May 17 and concluding on June 14, the government presented evidence in a bench trial before Judge Myerscough. In the verdict, filed this week, the court found Toran responsible for the company’s fraudulent overbilling to the state of Illinois and Medicaid for services not rendered, not rendered to the extent claimed, and for mileage well in excess of miles actually driven. During the period of the conspiracy, from December 2005 to June 2011, IBT billed and was paid claims totaling approximately $7.3 million. Evidence was presented that IBT overbilled the state’s Medicaid program by an estimated $4.7 million.
Despite rules clearly set forth in the state handbook, the court found that IBT billed for deceased individuals and individuals who were not transported because they were in the hospital. Further, IBT billed based on the dates the individuals were approved for transportation, whether they rode or not, even though route sheets showed who was transported daily. At times, IBT billed for more riders than it could physically transport. Further, the court found that although the handbook mileage rules were straightforward, that transportation providers could only bill mileage for the first rider, Toran directed billers to incorrectly bill for mileage - from not billing mileage at all, to billing mileage for all riders, and later, every fourth rider.
The court also found that various bank accounts and real estate constitute proceeds or property derived from proceeds, obtained by Toran, directly or indirectly, as a result of the offenses of conviction, including: $69,382 representing proceeds from the sale of property at 9544 S. Vanderpoel Ave., Chicago; 1450 W. 112th Place, Chicago; 28 Carrington Court, Hazel Crest, Ill.; $205,439, representing proceeds from the sale of property at 5741 and 5751 to 5759 South Halstead, Chicago; and, at 6978 West North Ave., Chicago.
Both Toran and Kimbrough remain on bond pending sentencing. At sentencing, the maximum statutory penalty for conspiracy to defraud (one count as to each defendant) is up to five years in prison; for each count of mail fraud (Toran seven counts; Kimbrough one count) is up to 20 years in prison. The penalty for making a false statement is up to five years in prison.
The charges were investigated by the Illinois State Police, Medicaid Fraud Unit; the U.S. Department of Health and Human Services, Office of Inspector General, Office of Investigations; the Federal Bureau of Investigation; and the U.S. Postal Inspection Service. In addition, the Illinois Department of Health and Family Services, which administers the Medicaid program for the state of Illinois, assisted in the investigation. Assistant U.S. Attorneys Gregory K. Harris and Timothy A. Bass are prosecuting the case.