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This archive displays posts tagged as relevant to ambulance services and ambulance service fraud.

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July 21, 2020

The Montachusett Regional Transit Authority (MART), a quasi-public transportation authority that brokers medical transportation, will pay $300,000 to resolve allegations that it improperly caused false claims to be submitted to MassHealth, the Massachusetts state Medicaid program. MART allegedly did not have appropriate procedures in place to verify that its transportation subcontractors had actually provided rides as they claimed, and MART billed MassHealth for thousands of rides that were not, in fact, provided. MA; USAO MA

June 30, 2020

Clifford P. Shomake and Kimberly Clyde “Casey” Conner, the owners of Guam Medical Transport, were sentenced to 6 years and 5.25 years, respectively, following their guilty pleas to charges arising from their conspiracy to defraud Medicare and TRICARE by submitting claims for reimbursement for medically unnecessary ambulance services that GMT provided to patients with end stage renal disease, despite knowing that the individuals did not qualify for ambulance transport under applicable regulations.  Defendants admitted that the conspiracy resulted in improper payments to GMT of approximately $10.8 million, and restitution in that amount was also ordered.  DOJ

September 27, 2019

Meridian Mobile Health, L.L.C., based in Bangor, Maine and doing business as Capital Ambulance, will pay $138,300 to resolve claims that it violated the False Claims Act by billing Medicare for non-emergency transportation.  The ambulance company, which voluntarily disclosed the billings to the U.S. Attorney's office, claimed that it had been provided with incorrect and/or incomplete information from Eastern Maine Medical Center regarding discharged patients in need of transportation.  USAO ME

August 29, 2019

International SOS Assistance, Inc. and related entities and individuals have agreed to pay $940,000 to resolve claims that they overbilled TRICARE for air medical evacuation services provided to military service members and their families.  International SOS was alleged to have negotiated discounts from third-party air ambulance services, but failed to pass those discounts on to TRICARE.  The case was brought by a whistleblower who used to be a flight desk manager for International SOS; he will receive an award of $165,000.  USAO EDPA

August 15, 2019

North Carolina ambulance company Gate City Transportation has been ordered to pay $5.25 million in restitution for falsely billing the state's Medicaid program for convalescent ambulance services when, in fact, the company was providing only medical van service to ambulatory and wheelchair-bound patients.  During the investigation, agents confiscated more than $5 million in cash and property, which will be applied to the restitution.  USAO MD NC

July 10, 2019

Rural Metro of Southern Ohio, Inc. has agreed to pay $275,116 to resolve allegations of submitting, or causing the submission of, false claims to Medicare.  In a qui tam suit brought by Nicholas Ratterman, a former employee, Rural Metro was alleged to have billed Medicare for medically unnecessary overnight hospital discharge ambulance transports between 2013 to 2017.  As part of the settlement, Ratterman will receive about $44,000.  USAO EDKY

June 20, 2019

Hart to Heart Ambulance Services, d/b/a Hart to Heart Transportation Services, has agreed to pay $1.25 million to settle allegations that it defrauded Medicare by submitting claims for medically unnecessary services, violating the False Claims Act.  Allegations were first brought to the government’s attention by former employee, Bryan Arvey, who alleged that from 2010 to 2017, Hart to Heart management pressured employees to falsify claims for non-emergency ambulance transports, such as hospital discharges.  For aiding in the recovery of public funds, Arvey will receive a share of $251,000.  USAO MD

Question of the Week — Is it time for a legislative fix to limit sky high air ambulance costs?

Posted  06/14/19
Emergency Personnel Rushing to Helicopter Ambulance
As rural hospitals continue to shutter, accessible emergency medical care is out of reach for an increasing number of Americans. When health emergencies arise, patients in rural communities often must rely on helicopter ambulances to get them quickly to care. But the Government Accountability Office reported the median cost for a helicopter ambulance ride was over $36,000 in 2017. The problem will likely continue...

May 2, 2019

Chimes Delaware, which provides services to individuals with developmental disabilities in Delaware, will return $4.5 million in Medicaid funding to the state to resolve claims of billing errors in its supported employment programs and transportation services.  Chimes also agreed to institute new internal controls and billing procedures.  DE

April 4, 2019

Lee County Ambulance of Lexington, Kentucky, and its former director Joseph Broadwell, will pay $253,930 to settle a False Claims Act action alleging that defendants submitted fraudulent claims to Medicare for unnecessary non-emergency ambulance transports, including transportation of patients to and from dialysis treatment.  USAO ED KY
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