A New Mexico driver admitted she worked with a non-emergency medical transport company to submit millions in bogus Medicaid claims for trips that never happened.
Dorothea Irving, 47, of Farmington pleaded guilty earlier this week after investigators say she and a transport company submitted false records to New Mexico Medicaid. Authorities allege the scheme created claims for ineligible or non-existent trips to medical appointments and inflated payments over multiple years. The case centers on non-emergency medical transportation billing practices and the records used to support those claims.
Court documents say Irving worked as a driver between 2020 and 2026 for a company that provided non-emergency medical transportation. Prosecutors contend she used her role to generate false trip records that the company then turned into claims submitted to the New Mexico Medicaid program. That program covers transportation to routine medical services for Medicaid recipients who lack access to a personal vehicle or public transit.
Instead of transporting eligible Medicaid beneficiaries, Irving and others allegedly fabricated trips naming Irving or her children as the recipients supposedly lacking transportation. The filing says drivers falsely reported attending on behalf of minors and logged trips that never took place. In many cases the false records claimed long-distance travel to Alcoholics Anonymous meetings across New Mexico to justify high-mileage billing.
The scheme also reportedly involved drivers signing forms to indicate they had driven one another, a tactic meant to disguise trips that were actually self-driven. Prosecutors say the company used those forms to submit multiple claims, sometimes billing separately for each passenger in a single vehicle. That method multiplied reimbursements and hid the true nature of the travel from Medicaid auditors.
Financially, the case documents quantify the fraud in the millions. For trips that listed Irving and her children as the Medicaid recipients without transportation, the company is said to have submitted approximately $3,957,788 in fraudulent claims and to have received approximately $4,142,942 from Medicaid. Irving herself allegedly received approximately $980,901 from the company over four years of the scheme.
Irving pleaded guilty to conspiracy to commit healthcare fraud and faces significant penalties under federal law. A sentencing date has not been set, and she faces a maximum penalty of 10 years in prison if the court imposes the statutory maximum. Any sentence will be determined by a federal district court judge after considering the U.S. Sentencing Guidelines and other statutory factors.
The Department of Justice announcement named several senior officials connected to the case, and identified the agencies involved in the investigation. Assistant Attorney General Colin M. McDonald of the Justice Department’s National Fraud Enforcement Division; Special Agent in Charge Justin A. Garris of the FBI Albuquerque Field Office; Special Agent in Charge Jason E. Meadows of the Department of Health and Human Services Office of Inspector General (HHS-OIG); Acting Special Agent in Charge Scott Brown of the IRS Criminal Investigation’s Phoenix Field Office (IRS-CI); and Director Jessica Randall of the New Mexico Medicaid Fraud Control Bureau made the announcement. Investigations are continuing with participation from the FBI, HHS-OIG, IRS-CI, and the New Mexico Medicaid Fraud Control Bureau.
Prosecutors handling the case include Trial Attorney Lauren Randell of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Katherine Lewis for the District of New Mexico. Their roles are focused on preparing the matter for sentencing and any related proceedings. The federal team says the case fits within broader national efforts to target health care fraud.
The Justice Department recently announced the creation of the National Fraud Enforcement Division (“Fraud Division”) to concentrate enforcement activities against fraud targeting federal programs. The Department states the Fraud Division is laser-focused on investigating and prosecuting those who commit fraud against the American people, and that its work supports President Trump’s Task Force to Eliminate Fraud, a whole-of-government effort chaired by Vice President J.D. Vance to eliminate fraud, waste, and abuse within Federal benefit programs. The Department highlighted the Health Care Fraud Strike Force Program, noting that the strike forces have charged more than 6,200 defendants who collectively billed federal healthcare programs and private insurers more than $45 billion since 2007, and that Centers for Medicare & Medicaid Services and HHS-OIG are taking steps to hold providers accountable.
