Empowerment Non-Emergency Medical Transportation, Inc. Data Breach (2014)

From 2011 to 2014, in the Northern District of Indiana, the defendant knowingly engaged in a scheme to defraud Indiana Medicaid and knowingly misused the means of identification of Medicaid clients. As part of the fraud scheme, the defendant caused billings and claims for reimbursement to be sent to Indiana Medicaid for transportation services that were never in fact provided. Defendant Wanda Shorter caused billings and claims for reimbursement to be sent to Indiana Medicaid as well for the payment of inflated mileage claims and for medical transportation trips that had been cancelled and never occurred. Further, the defendant caused billings to be sent to Medicaid that were up-coded, that is, the defendants caused billings to be sent that were submitted for higher reimbursement amounts than were justified based on the actual transportation services provided. As part of the fraud scheme, the defendant knowingly used without lawful authority a means of identification of other persons during and in relation to her health care fraud scheme, including specifically that of multiple Medicaid beneficiaries. The loss caused by the fraud here was in excess of $1 million dollars.