A transportation service that pays for people’s rides to medical appointments is among the Medicaid-funded programs facing new scrutiny for its vulnerability to fraud, with some in the industry saying they have been raising red flags for years.

The program, known as nonemergency medical transportation, provides tens of thousands of rides per year across the state and has, over the years, prompted scrutiny from legislative auditors and was a focus of a massive Medicaid fraud investigation.

Now it’s the topic of a new video released Jan. 14 from conservative influencer Nick Shirley, whose previous video alleging widespread fraud at Somali-owned Minnesota child care centers went viral. That video prompted the Trump administration to freeze child care funds to the state and launch a Department of Homeland Security investigation into the centers.

People working in nonemergency medical transportation “have been ringing the fraud bell for quite some time,” said Scott Isaacson, president of the Minnesota R-80 Transportation Coalition, which represents many providers. He shared a list with the Minnesota Star Tribune of the 10 most prevalent forms of fraud in the program that he and others in the field are aware of.

Under federal law, states must provide Medicaid recipients transportation to appointments if needed. The transportation providers contract with the government and managed care organizations to do that work, bringing people around the state to everything from dentist visits to dialysis appointments to addiction treatment.

The program, along with many other Medicaid-funded services, have seen expenditures climb in recent years. Minnesota Department of Human Services’ data shows nonemergency medical transportation providers billed around $80 million in 2018. By 2024, that climbed to more than $115 million before dipping last year to roughly $88 million.

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Prosecutors said billions of dollars in taxpayer money may have been abused in the 14 programs.

Nonemergency medical transportation providers were a major focus in an extensive, years-long investigation by Medicaid fraud prosecutors in the Minnesota Attorney General’s Office, called PITSTOP-66. More than 30 people have been charged in that investigation, which looked at a range of fraudulent activities tied to Faribault residents being transported to Twin Cities medical specialists.

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Nick Shirley video

The transportation providers Shirley highlights in his video are not listed as having received reimbursements from the state in Medicaid claims data provided by the Department of Human Services. Information on providers who billed for a very small number of services were not included in the data.

In Shirley’s video he appears alongside David Hoch, the same man who spirited him around Somali-run day cares. Hoch said in the video that the transportation services are the “heart” of the social services fraud scandal that has thrust Minnesota into the national spotlight and continued to blame the Somali community for fraud.

“All of this fraud revolves around these transportation companies,” Hoch said in the video, claiming the Medicaid-funded drivers ferry people to other programs that have faced fraud allegations, including autism treatment centers.

Shirley and Hoch visited providers that offer transportation, health services and day care in Minneapolis and several Twin Cities suburbs and came to the conclusion that the companies are responsible for over $11 million in fraud, largely using observations to assert the providers are operating illegitimately.

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