SPRINGFIELD, Ill. – A Chicago man has been sentenced to five years in prison for fraudulent overbilling an estimated $4.7 million to Illinois’ Medicaid program for non-emergency medical transport. Gregory D. Toran, 68, of Hazel Crest, Ill., was also ordered to pay $4.7 million in restitution. U.S. District Judge Sue E. Myerscough, who sentenced Toran on Jan. 23, allowed Toran to remain on bond until the federal Bureau of Prisons directs him to self-report to a prison facility to begin his prison sentence.
Toran owned IBT Transportation, LLC., a non-emergency medical transport company, with Tina Kimbrough, 44, of Berwyn, Ill. In August, Kimbrough was sentenced to 30 months in prison for her role in the scheme. Kimbrough previously pled guilty to participating in the conspiracy with Toran. Kimbrough was also ordered to pay $4 million restitution, due jointly and severally with Toran.
As a result of the scheme, IBT fraudulently overbilled the state’s Medicaid program by an estimated $4.7 million 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.
The court found that IBT billed for deceased individuals and individuals who were not transported because they were in the hospital and billed based on dates individuals were approved for transportation, whether they rode or not. 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 charges were investigated by the Illinois State Police Medicaid Fraud Control Bureau; the U.S. Department of Health and Human Services, Office of Inspector General, the Federal Bureau of Investigation; and the U.S. Postal Inspection Service. In addition, the Illinois Department of Health and Family Services, which administers Illinois’ Medicaid program, assisted in the investigation. Assistant U.S. Attorneys Gregory K. Harris and Timothy A. Bass prosecuted the case.