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

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December 21, 2018

Providence, Rhode Island-based Professional Ambulance, Inc., will pay $300,000 to resolve claims that it billed Medicare and Medicaid for ambulance services that were not medically necessary.  Specifically, the company transported dialysis patients, who require regular trips to and from a treatment facility, but many of whom were not eligible to travel by ambulance because they were sufficiently mobile.  USAO RI

October 16, 2018

A Medicaid transportation provider, its president, and a driver have been sentenced to pay a $10,000 fine and serve 2-4 years in prison for stealing a total of $1.2 million from New York's Medicaid program. The driver who was sentenced, Haimid Thompson, was accused of paying a Medicaid recipient to enroll in services from his employer and submitting falsified logs showing daily trips on behalf of the recipient. He was ordered to pay $23,598. The company, 716 Transportation, Inc., was sentenced to a fine of $10,000, and the president, Wossen Ambaye was ordered to pay restitution of $900,497, for knowing the services billed were not actually provided. NY AG

Catch of the Week — Ambulance Company and Clients Busted for Illegal Kickbacks and Cozy Financial Relationships

Posted  08/31/18
Here’s a question you shouldn’t have to ask when you’re in an ambulance: Did a bribe put me here? Our Catch of the Week goes to a $21 million settlement of a case against several ambulance-industry companies for allegedly paying kickbacks to secure lucrative exclusive contracts. Paramedics Plus, the East Texas Medical Center, the Emergency Medical Services Authority (EMSA), and EMSA’s president and CEO Herbert...

August 27, 2018

Following a lawsuit by whistleblower Dr. Stephen Dean, seven defendants in the ambulance industry have agreed to pay over $21 million altogether in order to settle claims that they violated the Anti-Kickback Statute and False Claims Act. The defendants with the largest fines—East Texas Medical Center and Paramedics Plus—had been accused of giving kickbacks to the others in exchange for their business. For his role in the case, Dr. Dean will receive $4.9 million. DOJ; EDTX

August 20, 2018

The owner of an ambulance company has been convicted of defrauding Medicare by submitting claims for over $3 million in unprovided or unnecessary transport services. Anthony Nwosah of Tonieann EMS and Rosenberg EMS also admitted to falsifying and instructing others to falsify transport records, as well as submitting some under the name of an EMT who didn’t even work for him. He received $1,094,260 before the fraud was uncovered, and at his sentencing in November, he stands to receive a $250,000 fine and ten year sentence. USAO SDTX

July 26, 2018

New York announced guilty pleas by transportation company 716 Transportation, Inc., its president, and one of its drivers, in connection with a $1.2 million Medicaid fraud scheme. The company and its president admitted to billing Medicaid for transportation services that were either never provided or that violated Medicaid rules and regulations. NY AG

July 17, 2018

County Ambulance, Inc. has paid $16.7K to settle allegations that it violated the FCA by using money it received from Medicare and Mainecare to pay the salary of an employee who had previously been excluded from those programs. USAO Maine

July 10, 2018

Liberty Ambulance agreed to pay $1.2 million to settle an FCA qui tam alleging that, from 2005 to 2016, Liberty had fraudulently upcoded life support services and unnecessarily transported patients.  The case was filed by whistleblower Shawn Pelletier, who will receive $264,000 from the settlement, on top of $1.2 million he had received from prior settlements with other defendants.  USAO MDFL

February 23, 2018

Maine-based North East Mobile Health Services agreed to pay $825,000 to settle claims it violated the False Claims Act by providing medically unnecessary ambulance transportation. Maine Medical Center also agreed to pay $600,000 pursuant to a separate civil settlement. According to the government, North East improperly billed Medicare for ambulance transports of patients it falsely claimed were either “bed-confined” or for whom such transport was otherwise medically necessary. The government further alleged that MMC personnel provided North East with statements containing incomplete or inaccurate information about the medical necessity of transporting patients by ambulance, which North East thereafter used to bill Medicare. DOJ (ME)

January 30, 2018

Tampa’s largest ambulance providers AmeriCare Ambulance Service, Inc. and its sister company AmeriCare ALS, Inc. agreed to pay roughly $5.5 million to settle claims they violated the False Claims Act by billing Medicare for medically unnecessary ambulance transportation services. The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former AmeriCare employee Ernest Sharp. He will receive a whistleblower award of roughly $1.15 million from the proceeds of the government’s recovery. DOJ (MDFL)


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