New Windsor couple pleads guilty to $3.4M Medicaid transportation scheme

Rohail Raja, age 45, of New Windsor and his wife, Sharma Alam, age 45, also of New Windsor, plead guilty for their involvement in a Medicaid transportation scheme which defrauded the state of more than $3 million.

On May 14, Raja plead guilty in Orange County Court to grand larceny in the first degree, while Alam plead guilty to the felony charge of conspiracy in the fourth degree. Raja and Alam, who own Medicaid transportation companies, Unique Class Limo, Inc., and SNR Limo, Inc., respectively, admitted to fraudulently billing the New York State Department of Health for Medicaid transports that either did not occur at all, or did not occur in the manner that demands for payment indicated. At the time that they pleaded guilty, Raja and Alam each admitted that $3,434,730 was stolen from New York State’s Medicaid program pursuant to this fraudulent billing scheme.

Pursuant to the plea agreements placed on the record at the time the defendant’s plead guilty, both Raja and Alam will be ordered to pay restitution in the amount of $3,434,730. If Raja and Alam pay $1,000,000 toward that restitution prior to being sentenced, Orange County District Attorney David Hoovler’s office will recommend that Raja be sentenced to four to 12 years in state prison.

The defendants are next scheduled to appear in Orange County Court on Sept. 9.

Background

A joint investigation was conducted by the Orange County District Attorney’s Office, the Office of the New York State Comptroller, the Orange County Sheriff’s Office, and the Orange County White Collar Crimes Taskforce. They were assisted in the investigation by the New York State Office of the Medicaid Inspector General and the Hudson Valley Crime Analysis Center. Based upon information developed during the investigation, the District Attorney’s Office applied for a search warrant which was executed at the defendants’ Town of New Windsor residence by investigators of the Orange County District Attorney’s Office and Orange County Sheriff’s Office, who were accompanied by investigators from the Office of the State Comptroller.

During the investigation, claims for payments submitted by the defendants’ companies were compared to records from the Medicaid medical service providers named in the claims. A forensic auditor of the Office of the New York State Comptroller discovered that the New York State Department of Health had paid the defendants for ostensibly transporting Medicaid recipients to Medicaid health care providers on dates and time when the provider records show that no such visits occurred.

In addition, a review of the claims submitted by those companies during that same time period disclosed that the defendants’ companies were fraudulently submitting claims to the New York State Department of Health which falsely indicated that the companies had transported Medicaid recipients separately to medical appointments, when in reality they had transported multiple Medicaid recipients in one trip. It is alleged that the defendants fraudulently billed the Department of Health by claiming that the transport for each Medicaid recipient was a separate trip. As a result of all the false claims, between April 15, 2020 and September 30, 2024, the defendants’ companies received more than $3,434,730 than they were entitled to.

District Attorney Hoovler said, “This is the largest Medicaid fraud scheme ever prosecuted by the Orange County District Attorney’s Office. I am grateful to Comptroller [Thomas] DiNapoli and his staff for partnering with the District Attorney’s Office and the Orange County White Collar Crimes Taskforce on this important investigation. The work of the investigators and forensic auditors of the Office of State Comptroller was crucial to this investigation. I also thank Sheriff Arteta for continuing to partner with my office, and the other members of the White Collar Crimes Taskforce for their dedication to investigate complex financial crimes.”

The case is being prosecuted by Chief Assistant District Attorney Christopher Borek.