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

Joseph Carl and Randolph Ekstrom Charged in Superseding Indictment 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. 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.