Federal pursuit of anti-kickback statute takes millions from local EMS

Expert witness commentary on the recent Paramedics Plus litigation, in which the government alleged violations of the federal Anti-Kickback Statute


By Doug Wolfberg

I served as an expert witness in the recent Paramedics Plus litigation, in which the government alleged violations of the federal Anti-Kickback Statute (AKS) in procuring contracts, principally in Oklahoma. As this case represents one of the largest federal settlements in EMS history, I’d like to provide some commentary on the lawsuit and what it means for the industry.

In my background as an EMS attorney with the Page, Wolfberg & Wirth law firm; as a professor of healthcare law; an EMS1 columnist; and as a former county, state and federal EMS official, I have worked extensively in applying, analyzing and advising clients under the federal AKS. My partner Steve Wirth and I each have about 25 years experience working specifically with the AKS. Never before have we seen such a misapplication of this law by the federal government – and this unfortunate prosecution can have significant effects on local EMS systems across the United States.  

The AKS cannot properly be applied to a situation where a public agency awards a contract to an ambulance company, but where it’s the public agency itself which bills Medicare and other federal healthcare programs for the ambulance services rendered. Under its Oklahoma contract, EMSA – the public agency – owned and operated all of the ambulances, and Paramedics Plus was awarded a contract to staff those ambulances. This is a type of public utility model (PUM) contract.  

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