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Ambulance company owner pays over $2 million in fraud case

The federal government is not shy when it comes to allegations of healthcare fraud. These investigations can include pretty much anyone that operates in the healthcare marketplace, from physicians and nurses to large hospitals and independently operated ambulance companies, as long as they bill Medicare or Medicaid. If the feds find evidence to support allegations that an organization did not properly bill Medicare or Medicaid, they will pursue charges — and these charges can come with massive payouts. In a recent case, the government got over $2 million from a single small ambulance company.

Feds investigate ambulance company owner over transportation costs

The feds claim the owner of the ambulance company encouraged his employees to falsify patient records. Why? Medicare generally covers the cost of transportation to dialysis appointments in wheelchair accessible vans or, if the patient cannot use these vans, ambulance services. The prosecution claims the patients did not require the use of an ambulance for transportation. Instead, they state the owner had his workers alter the records to indicate that the patients required this form of transportation.

If the feds could support these claims, they likely have a strong health care fraud case against the ambulance company owner. 

Investigation leads to charges, courts find in favor of the feds

The prosecution presented the court with evidence of one patient walking from the ambulance into her appointment and falsified billing documents. Upon review, the federal judge ordered the ambulance company owner to serve 12 months’ probation and pay a $500,000 fine in addition to over $2 million in restitution.

Ambulance company owners and others who bill Medicare and Medicaid should take note

These types of allegations are not uncommon. Those who are notified of an investigation are wise to take the matter seriously. An attorney can review the situation and discuss your options.

Attorney John Rivas is responsible for this communication