Massachusetts officials billed Medicaid for nearly 17,000 fake trips transporting alleged beneficiaries of the massive federal health care programs to obtain medical services that were never provided, according to a deep-dive data analysis by Open the Books (OTB).

There were at least 4,417 non-emergency, tax-funded emergency transports by Medicaid service providers in 2018, according to the federal and state Medicaid documents examined by OTB, the Florida-based government watchdog with the largest database of federal, state, and municipal government spending ever assembled on the internet.

By 2022, that number had skyrocketed to approximately 22,228, marking a 403% increase in only four years. The total number of transport claims in Massachusetts for Medicaid-paid transportation declined somewhat in 2024, the most recent year for which data is available, to approximately 18,000.

Massachusetts officials weren’t unaware of these data in the state’s MassHealth program that works through Medicaid, and there were a few significant prosecutions of fraudsters billing Medicaid for the ghost rides in the Bay State during the period, according to OTB.

“Bakali Mukasa billed MassHealth for rides to methadone clinics that were never driven. His Waltham-based company, JBM Health and Educational Services Inc., collected more than $770,000 from Massachusetts Medicaid for 16,907 trips that did not happen, including nearly 100 trips billed for patients who were already dead,” OTB explained.

Mukasa’s fraudulent activities weren’t noticed, however, until officials realized the patients allegedly receiving the transports had previously been issued medication, suggesting there was no actual reason for many, if not all, of the trips. Those billings would have remained hidden, however, had not somebody in an oversight position put an unlikely two and two together.

Mukasa was charged by the Massachusetts Attorney General (MAG) with multiple charges of filing false claims, money laundering, and larceny. The funds received from the government were allegedly transferred to Uganda, where Mukasa lives, using real estate and investment accounts. 

“Less than a year earlier, the same office indicted Ardit Islamaj, 36, and his Worcester-based Instant Transportation LLC on 17 counts: Medicaid fraud, larceny, patient abuse, identity fraud, money laundering, and witness intimidation. Between August 2018 and August 2023, Islamaj allegedly billed MassHealth more than $3 million for rides that never occurred, including trips for deceased patients, hospitalized patients, and patients who had cancelled. Employees were instructed to impersonate MassHealth members to inflate trip counts. A former employee was paid thousands of dollars to stay quiet before meeting with investigators,” OTB reported.

Neither state nor federal officials can be certain there are not multiple similar fraud schemes still in operation in Massachusetts — in part because the Department of Health and Human Services’ (HHS) Centers for Medicare and Medicaid (CMS) regulations have a self-imposed blind spot in their oversight of state administration of transportation funding.

“CMS suppresses data for providers that submit fewer than 11 claims per period, to protect patient privacy. That threshold means small operators, precisely the type of company most likely to run a short-lived fraud scheme, may not appear in the public record at all,” according to OTB. Mukasa’s activities went undetected for years due to this flaw.

“The public record had no way to flag them,” OTB said in its analysis.

Members of the House Committee on Energy and Commerce, however, are conducting a continuing investigation of Medicaid fraud that specifically encompasses Massachusetts, along with a dozen other states, including Minnesota. The committee has convened multiple hearings on the issue but has not yet issued a report of its findings or recommendations.

Committee Chairman Rep. Brett Guthrie (R-Ky.) and two subcommittee chairmen, Rep. John Joyce (R-Pa.) and Rep. Morgan Griffith (R-Va.), told Massachusetts Democratic Governor Maura Healey and Kaime Mahanniah, secretary of the state’s Health and Human Services office, in an eight-page March 3, 2026, letter that they are concerned that long-running health care fraud schemes in Minnesota are being duplicated in Massachusetts and elsewhere.

“In fiscal year 2024, Massachusetts Medicaid (MassHealth) spending totaled over $26 billion ($14.7 billion in federal funding) and covered over 1.6 million people. According to the Governor’s 2026 budget, MassHealth spending is expected to increase 12.6 percent in fiscal year 2026. The Massachusetts State Auditor Diana DiZoglio recently announced that the Bureau of Special Investigations (BSI) identified $1.3 million in MassHealth fraud in fiscal year 2025. Massachusetts broadly defines Medicaid eligibility and administers several Medicaid programs that are considered high risk for [waste, fraud and abuse],” the House panel officials said in the letter.

Mahanniah responded on March 17 with a 41-page letter, including multiple appendixes, in which he argued state officials are working closely with federal workers in policing fraudulent claims in the Medicaid program. Among much else, Mahanniah included a chart indicating state officials were responsible for recovering, on average, $86 million in improper Medicaid payments each year between 2021 and 2025. He also contended that state officials’ basic approach to waste, fraud, and abuse in tax-paid health care programs reflects the fact that “the majority of MassHealth’s controls operate before payment — through pre-pay edits, algorithmic review, and clinical authorization requirements — meaning a significant share of improper payments are stopped before dollars go out the door, ensuring that they never have to enter the payment recovery pipeline.”

The Washington Stand could not learn whether Guthrie or other committee members have issued assessments of the quality or relevance of the lengthy response from Mahanniah, but during a hearing on the same date of the Massachusetts official’s lengthy letter, Guthrie pointed to widespread fraud in Medicaid in multiple other states.

“In Medicaid, schemes are running rampant in a variety of programs, from non-emergency medical transportation to personal care services, autism therapy, and substance use disorder treatment. These crimes are despicable, yet we are seeing them occur time and time again across the country. In Minnesota, it’s Medicaid [Applied Behavior Analysis] ABA therapy services. In California, it’s Medicare hospice services. In Florida, it’s Medicare durable medical equipment. Once caught, fraudsters might be stopped, but they are always looking for their next scheme. The tentacles of these criminal schemes are long, and they reach into many different areas of health care,” Guthrie said in his opening statement for the hearing.

“And many of these fraud schemes target vulnerable individuals, such as the elderly, individuals with disabilities, the homeless, and people struggling with substance abuse disorders. Moreover, taxpayers are being defrauded of outrageously large amounts of money. Pennsylvania’s Governor Josh Shapiro, during his time as Pennsylvania’s Attorney General, stated at a 2020 press conference, ‘It’s possible, no, likely, that Pennsylvania is losing $3 billion a year to fraud.’ And that’s just one state, and that’s just in one year,” Guthrie continued.