Copyright 2006 The Patriot Ledger
Mass. ambulance service overcharged Medicare, auditors say
By SUE REINERT
The Patriot Ledger (Quincy, Mass.)
American Medical Response of Massachusetts overcharged Medicare at least $1.9 million for ambulance services during six months in 2002, federal auditors say.
The company, which serves several South Shore communities, carried patients who did not need emergency transport and billed for services that Medicare does not cover or that it did not provide, the inspector general of the Department of Health and Human Services found.
The audit covered the period from July 1, 2002, to Dec. 31, 2002, which was shortly after the company agreed to pay $20 million to settle similar allegations of improper billing.
The most recent findings, made public on Monday, were based on a sample of records for 100 Medicare patients.
The findings show that the company “did not have effective billing controls,” the audit said.
A company spokesman said yesterday that he was not aware of the audit.
In its written response to the findings, the company agreed that some bills were improper but said about 80 percent of the charges identified in the audit were legitimate.
In 2002, the company agreed to pay $20 million to settle allegations that it bilked Medicare by making thousands of false claims in Massachusetts from 1993 to 1998. Most of the charges involved claims made by independent ambulance companies that were purchased by Colorado-based American Medical Response.
A federal whistle-blower lawsuit charged American Medical Response and the now-defunct companies with seeking reimbursement for non-emergency ambulance transportation between January 1993 and December 1998. As part of the settlement, the company agreed to strengthen its billing controls.
Auditors have recommended that American Medical Response repay almost $1.8 million to Medicare. The inspector general gave the company credit for about $181,000 that the company already refunded as a result of its own review of billing during the period that was examined.