New Windsor Couple Charged with Stealing $2.9 Million Through Fraudulent Medicaid Transportation Claims

New York authorities have arrested a couple in what officials describe as the largest Medicaid fraud scheme ever prosecuted in Orange County, allegedly bilking the state healthcare system out of nearly $3 million through elaborate transportation billing schemes.

Rohail Raja, 45, and his wife, Sharma Alam, 45, both of New Windsor, were arrested Thursday and charged with Grand Larceny in the First Degree. According to New York State Comptroller Thomas P. DiNapoli and Orange County District Attorney David M. Hoovler, the couple orchestrated a complex fraud operation through two Medicaid transportation companies they owned.

The investigation, conducted jointly 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, uncovered fraudulent activity spanning more than four years, from February 2020 through August 2024.

Authorities allege the defendants employed two primary schemes to defraud taxpayers. In the first method, investigators discovered the companies submitted claims totaling over $2 million for transporting Medicaid recipients to healthcare appointments that never occurred. Auditors from the State Comptroller’s office cross-referenced billing records with healthcare provider documentation and found numerous instances where Raja and Alam billed for services on dates when patients had no scheduled appointments.

The second scheme involved billing separately for multiple patients who were actually transported together in the same vehicle. Rather than submitting a single claim for group transportation, the companies allegedly filed individual claims for each patient, fraudulently collecting an additional $895,000 through this practice.

“This is the largest Medicaid fraud scheme ever prosecuted by the Orange County District Attorney’s Office,” said District Attorney Hoovler. “The work of the investigators and auditors of the Office of State Comptroller was crucial to this investigation.”

Comptroller DiNapoli emphasized the impact of such fraud on public resources, stating, “These defendants allegedly systematically schemed to steal nearly 3 million dollars in much needed funds for the health care of deserving New Yorkers.”

The alleged fraud strikes at the heart of the Medicaid transportation system, which serves as a critical lifeline for vulnerable populations. Medicaid transportation providers are authorized to help recipients travel to and from approved medical appointments, with costs covered by the state health department. The program ensures that lack of transportation doesn’t become a barrier to necessary healthcare for low-income residents.

Medicaid fraud has become an increasing concern nationwide, with the National Health Care Anti-Fraud Association estimating that fraudulent healthcare activities cost taxpayers tens of billions of dollars annually. Transportation fraud schemes have proven particularly difficult to monitor due to the decentralized nature of the services.

Following their arrest, Raja and Alam were arraigned in the Centralized Arraignment Part. The court set bail at $1 million cash, $5 million partially secured bond, or $10 million unsecured bond. Both defendants were remanded to the Orange County Jail and are scheduled to appear in the Town of New Windsor Justice Court on November 5.

Officials conducted a search of the couple’s New Windsor residence as part of the ongoing investigation. Authorities are urging anyone with additional information to contact the Orange County District Attorney’s Office.

Orange County Sheriff Arteta highlighted the importance of the White Collar Crime Task Force in combating such schemes. “These investigations ensure that we hold the people taking advantage of public funding accountable. We need to prevent fraudulent claims from causing a burden on our Medicaid system so that the funding is there for those who need it,” Arteta said.

The case is being prosecuted by Assistant District Attorney Amanda Bettinelli and Chief Assistant District Attorney Christopher P. Borek. The defendants are presumed innocent until proven guilty.