Carl’s Cab Operators Charged in $4.2 Million Medicaid Fraud and Kickback Scheme

ALBANY, NEW YORK - A federal grand jury has returned a superseding indictment charging Joseph Carl, age 55, of Saratoga County, New York, and Randolph Ekstrom, a/k/a "Randy," age 48, of Saratoga County, New York, with conspiracy to commit health care fraud and wire fraud and conspiracy to pay health care kickbacks in connection with Medicaid transportation services. The charges filed in federal court are part of the Department of Justice's 2026 National Health Care Fraud Takedown.

The announcement was made by First Assistant United States Attorney John A. Sarcone III, Federal Bureau of Investigation (FBI) Special Agent in Charge Craig L. Tremaroli, U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Special Agent in Charge Naomi Gruchacz, and New York State Comptroller Thomas P. DiNapoli. This prosecution is part of the Trump Administration's Task Force to Eliminate Fraud.

"The superseding indictment alleges a sustained scheme to exploit the Medicaid program through false claims, inflated billing, and unlawful kickbacks," said First Assistant United States Attorney John A. Sarcone III. "If proven, this conduct reflects a deliberate effort to convert a taxpayer-funded health care program into a source of illicit profit, including by paying recipients with cash to facilitate fraudulent claims. My office will hold accountable those who corrupt public programs and divert public funds away from legitimate health care services and the patients who depend on them."

"These allegations describe deceptive actions-billing for services not rendered and bribing beneficiaries-that divert essential financial resources from the Medicaid program and the legitimate medical care it is meant to provide," stated Naomi D. Gruchacz, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). "HHS-OIG will continue working with our law enforcement partners to ensure that individuals suspected of abusing federal health care programs are investigated and, when appropriate, brought to justice."

"As alleged in the superseding indictment, Mr. Carl and Mr. Ekstrom stole over $4 million from critical Medicaid funds" said FBI Special Agent in Charge Craig L. Tremaroli. "Americans expect government funds to be used as intended, and this investigation proves the FBI will work with our Healthcare Fraud Task Force partners to leverage any resource necessary to investigate and hold accountable anyone looking to take advantage of our systems and line their own pockets at the expense of hardworking Americans."

According to the superseding indictment, between approximately January 2020 and March 2025, the defendants operated and were associated with Carl's Cab, a Medicaid-enrolled transportation provider. Medicaid is a federal and state health care program that reimburses providers for medically necessary services, including non-emergency transportation to medical appointments.

The superseding indictment alleges that the defendants engaged in a scheme to defraud Medicaid by submitting and causing the submission of claims for transportation services that were not provided, not medically necessary, or improperly inflated. The alleged fraudulent billing included claims for "ghost rides," claims for trips in which Medicaid recipients were not transported or not seen by medical providers, and claims that improperly increased reimbursement by treating group transportation as multiple individual trips.

The superseding indictment further alleges that the defendants paid cash and controlled substances to Medicaid recipients to induce them to use Carl's Cab as their transportation provider. These payments were intended to generate additional Medicaid reimbursements and to sustain the fraudulent billing scheme. During the course of the investigation, law enforcement recovered photographs depicting large amounts of U.S. currency prepared for distribution in furtherance of the alleged kickback scheme.

As alleged, the defendants caused the submission of false and fraudulent claims through the New York State Department of Health, which processed Medicaid reimbursements through systems located in Rensselaer County and transmitted payments through interstate wire communications. The alleged conduct resulted in the fraudulent receipt of at least $4,296,374.02 in Medicaid funds.

Carl and Ekstrom are charged with conspiracy to commit wire fraud and health care fraud, which carries a maximum sentence of 20 years in prison, a fine of up to $250,000, and a term of supervised release of up to three years. Carl and Ekstrom are also charged with conspiracy to pay health care kickbacks, which carries a maximum sentence of five years in prison, a fine of up to $250,000, and a term of supervised release of up to three years. A defendant's sentence is imposed by a judge based on the U.S. Sentencing Guidelines and other statutory factors.

As alleged in the superseding indictment, on August 17, 2023, Carl prepared cash payments to Medicaid recipients and messaged an acquaintance, "I'm stuffing envelopes!!!! $23,500!!!" and attached an unredacted version of the following photograph showing money used for bribes.

In addition, the superseding indictment alleges that on November 2, 2023, Carl prepared cash payments to Medicaid recipients and messaged an acquaintance, "Getting ready to stuff. $27,000 in envelopes for the junkies" and attached an unredacted version of the following photograph showing money used for the bribes:

Carl and Ekstrom were arraigned yesterday in Albany, New York, before United States Magistrate Judge Paul J. Evangelista, and were released pending trial scheduled for a date to be determined before United States District Judge Anthony J. Brindisi.

The charges in the superseding indictment are merely accusations. The defendants are presumed innocent unless and until proven guilty.

The Northern District of New York worked with the Department's Health Care Fraud Unit of the Fraud Division, together with the FBI, HHS-OIG, and the New York State Comptroller's Office, with additional assistance from the New York State Office of the Medicaid Inspector General.

Assistant United States Attorneys Benjamin S. Clark and Adam J. Katz are prosecuting the case.