Mechanicville man sentenced for Medicaid fraud
A Mechanicville man was sentenced to one year in prison and was ordered to pay back more than $3 million to Medicaid in Otsego County Court on Monday, March 24.
Chief Assistant District Attorney Christopher J. Di Donna said Philip Mtui pleaded guilty to first-degree attempted grand larceny in Otsego County Court March 3. He was sentenced by Judge John Lambert to one year in prison, told to pay back $3,165,413 to Medicaid and he agreed to never again engage in the Medicaid transportation business individually, as a corporation or through a third party.
Mtui, who was owner of Phinaliz Communications LLC, a company based in Otsego County, was arrested Aug. 24, 2023 after a joint investigation by the state Comptroller's Office, the Otsego County District Attorney's Office, the Otsego County Sheriff's Office, the Oneonta Police Department and the U.S. Department of Health and Human Services Office of Inspector General, a Daily Star archive article stated. The Otsego County Department of Probation, the Otsego County Department of Social Services, the New York State Department of Motor Vehicles, the Oneida County Sheriff's Office, the Saratoga County Sheriff's Office and the East Greenbush Police Department also assisted in the investigation.
Phinaliz Communications was enrolled in the Medicaid program as a participating transportation provider for Medicaid recipients, the article stated. Under Medicaid regulations, patients may use transportation services for legitimate appointments which are billed to the Medicaid program by the provider. The investigation revealed that during a four-year period Medicaid was billed for rides that didn't happen, or were billed double, triple or quadruple the rate of the rides that did occur, officials said previously.
Investigators found that Medicaid enrollees were being paid kickbacks by the company to use their service and provide their information to facilitate the alleged crimes, the article stated.
According to the article, the crime ring was exposed through a multi-year investigation by state, local and federal authorities involving extensive surveillance and the execution of a search warrant on company headquarters.
Mbaga Kaiza, who was the operational manager of the company, was also arrested in 2023, the article stated. Di Donna said Kaiza has not pleaded guilty to any charge and his trial is scheduled to begin May 5.
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