In a shocking statistic, Medicare paid out $5 billion to ambulance companies in 2012. That’s more than Medicare paid out to cancer and orthopedic doctors, according to recently released federal information. This data illuminates some possible fraud against Medicare.
Part of that $5 billion is accounted for by Penn Choice Ambulance Inc. The Philadelphia-based company is accused of defrauding the government of $1.5 million, part of which included drivers giving a four-block, unwarranted, weekly ride for a patient to a dialysis center. During the drive, according to an indictment against the company, the patient smoked cigarettes and chatted with the driver, costing taxpayers $1,000 each ride.
The U.S. Department of Health and Human Services reported that ambulance service is one of the largest areas of abuse in Medicare. Companies have been accused of billing millions of dollars for rides given to patients who are able to walk, stand, drive and sit. Basically, it seems, companies are trying to get over on the system by transporting anyone who requests a ride and then billing Medicare.
In the past year, government officials have stepped up their efforts to curtail the problem, with rides to dialysis centers being one of the largest areas of fraud. The Department of Health and Human Services estimated that Medicare overpaid ambulance services
While fire departments, hospitals and volunteer organizations used to dominate the ambulance business, more and more privately owned ambulatory care services have sprung up in recent years. Local governments have outsourced ambulances in order to cut costs. According to the Medicare Payment Advisory Committee, about one third of all ambulance companies billing Medicare are for-profit companies.
Penn Choice appears to be one of the major targets for Medicare fraud. According to the indictment, the company recruited patients for rides outside of dialysis centers and told them they could get Medicare to pay for it. They also received a list of passengers from Brotherly Love (closed for fraud in 2011), paying $2,000 each. In addition, Penn Choice is accused of giving envelopes of money to patients who continued to use the ambulance service.
The qui tam attorneys at Begelman & Orlow, P. C. have more than 115 years of combined experience litigating whistleblower cases throughout the U.S. If you have knowledge of any fraudulent activity, contact the whistleblower lawyers at Begelman & Orlow, P. C..