$4 million-plus in alleged Medicaid ride billing draws federal fraud charges in Colorado

By Shaina Cole | Contributing Writer, Rocky Mountain Voice

Colorado’s Medicaid transportation system operates on a straightforward premise.

A ride is provided to a qualified Medicaid recipient. Documentation is submitted. The state reimburses the provider.

For thousands of Coloradans, particularly those in rural communities or without reliable transportation — that structure makes routine medical care possible.

But federal prosecutors now allege that in two separate cases, the reimbursement model itself was manipulated.

Non-emergent medical transportation billing is the focus in the cases that have been filed in U.S. District Court this month regarding providers in Mesa and Douglas counties. The cases involve more than $4 million.

On Feb. 10, the U.S. Attorney’s Office for the District of Colorado announced federal charges accusing the defendants of wire fraud, healthcare fraud and money laundering.

Understanding the System

The non-emergent medical transportation (NEMT) service provides a means to access scheduled medical services such as dialysis, primary care, specialist services, behavioral healthcare–among others.

In Colorado, it is run by the Colorado Department of Health Care Policy & Financing, which contracts with regional brokers and local providers.

Providers submit claims after rides occur. Reimbursement follows documentation review.

It is a reimbursement-based structure, not a pre-approval model.

That’s where the system can get gamed.

Because payment is issued after services are reported, the system depends heavily on accurate documentation, mileage reporting, appointment verification, and cross-checking against eligibility records.

When those safeguards fail — or are bypassed — improper payments can accumulate before anomalies are identified.

Mesa County Allegations

Ashley Marie Stevens, 40, of Mesa County, is charged in a federal indictment with filing over $1 million in Medicaid transportation claims between July 2022 and February 2023 under the false name Armistead Twin Rides, LLC.

The prosecution claims that approximately $400,000 of that sum was related to rides that Stevens and her family members were charged for but that didn’t match up with actual doctor’s appointments.

Additional trips that allegedly never happened, locations unrelated to medical services, and daily mileage exceeding 400 miles per patient are all detailed in charging documents.

Four hundred miles in one day — repeatedly billed via a post-service verification-based reimbursement system.

Court filings allege that part of the alleged fraud funded a luxury car and personal travel.

A Second Case in Douglas County

Through a company called Sama Limo, prosecutors allege, Wesam Yassin billed about $3.3 million in NEMT claims over an 18-month stretch. The allegations appear in a separate Douglas County indictment.

Prosecutors allege that just 64 rides connected to one beneficiary generated roughly $283,000 in billing. About $165,000 of that amount, prosecutors allege, covered rides dated after the beneficiary’s death.

Prosecutors argue that other rides either didn’t happen or weren’t connected to any medical appointments. The indictment also alleges funds were used to purchase a home, vehicles, jewelry, and cosmetic procedures.

How Billing Irregularities Are Typically Flagged

Medicaid fraud investigations often begin with data review rather than field investigation.

Large claim volumes. Duplicate submissions. Mileage that does not align with realistic travel distances. Services billed after a recorded date of death.

The federal Medicaid Integrity Program supports states in identifying those patterns. When anomalies surface, cases may be referred to Colorado’s Medicaid Fraud Control Unit within the Attorney General’s Office. Federal partners — including the Department of Health and Human Services Office of Inspector General and the FBI — frequently assist.

Sometimes detection is algorithmic. Sometimes it comes from a tip — an employee, a competitor, or a beneficiary reviewing a statement of benefits.

The public rarely sees the early stages of that review process.

How early the alleged billing patterns were identified is still unknown in these cases. 

What remains unknown

Beyond those two indictments, the cases also raise a more general structural query about how well reimbursement safeguards function within the state of Colorado’s Medicaid transportation system and how quickly oversight procedures respond to changes when billing patterns start to diverge from those that are medically necessary.

The U.S. Attorney’s Office was contacted to ask about the process it used to identify these perceived problems. There were no further remarks.