Fraud
Every ambulance provider should review and update their billing and claims policies and procedures
Although Medicare and Medicaid rules are lengthy and confusing, EMS leaders and field providers must ensure compliance
Chiefs and field providers need to change the culture that condones fraud into one that truly determines competency
The investigation into Hart to Heart Transportation Services was launched after a whistleblower filed a lawsuit alleging they falsified Medicare claims
Kevin Davis was arrested for treating a teen, who later died of a drug overdose, at an illegal rave
Michael Tallant said he was terminated for sleeping even though it was considered “common”
Powell County EMS has been accused of billing the federal government for 2,400 fraudulent transfers since 2012
They allegedly billed the insurance companies for transporting people when it wasn’t medically necessary for them to go by ambulance
The owners admitted to submitting about $6 million in false claims
A former employee claimed the company falsified bills for ambulance services to qualify for higher Medicare reimbursements
Malachi Love-Robinson, 19, was arrested last year after officials said he was practicing medicine without a license
Officials allege personnel would file a false disability claim, collect a payout and return to work
Bassem Kuran was sentenced to 10 months in prison and must pay $66,000 in restitution
A prior conviction banned him from participating in U.S. health care programs
Officials require ambulance agencies to receive prior authorization for non-emergency trips in order to be paid by Medicare
Robert Gotay told police he had a severe gambling problem and admitted writing checks to himself from the ambulance organization’s account
A grand jury handed down indictments against Dustin Hazlewood for illegally obtaining fentanyl and morphine
Malachi Love-Robinson, 18, was arrested in February after deputies said he was practicing medicine without a license
At the time of Brandon Mitchell’s hire, six felony charges were pending against him in Oregon
Brad Reiter will face two to six years in prison after his seven-year scheme; the money was used to pay for credit card bills, lawn care and security system services
Brandon Mitchell was arrested for obtaining money by false pretenses; it was discovered he also faced charges of theft from his prior department
Expect more oversight of EMS billing through post-payment audits and increased investigations, prosecution
The 18-year-old was giving exams at a medical clinic; he had a five-star ranking on healthgrades.com
The lawsuit argues that the company, which mostly provides transport for dialysis patients, fraudulently billed Medicare for these rides as ambulance rides
The former EMS director and his wife were arrested after an audit uncovered the missing funds
Terry Johnson fraudulently billed the federal health insurance programs for about seven years for transportation services when patients were not transported
Two employees of the company pleaded guilty to conspiracy to commit health care fraud
An employee forged and copied doctors’ signatures on to Physician Certification Statements for transports that were medically necessary
The indictments name a husband, wife and two of their daughters for the long-running theft scheme
White Lake Ambulance Authority allegedly submitted hundreds of false insurance claims
The man is accused of pilfering funds from the organization between 2008 and 2015
1 in 5 ambulance companies had questionable billings and Medicare paid another $24M for ambulance rides that didn’t meet payment requirements
The owner faces up to 12 years in prison for getting reimbursements for patients that were never transported
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