The Central Florida branch of a national ambulance company accused of submitting fraudulent Medicare claims for patient transports will pay $650,000 in restitution to the United States in a settlement reached in late February, records show.
According to the settlement agreement, U.S. investigators allege Rural/Metro Corporation submitted claims to Medicare for services that were not medically necessary, and did not meet Medicare reimbursement requirements, over a nearly seven-year period ending in December 2016.
“[The U.S. alleges] the patients who were transported either did not qualify for such services or did not require ambulance transport... The United States also contends that the reasons for these transports was improperly documented,” William Daniels, a spokesman for the DOJ’s Middle District of Florida, said in a press release.
The Centers for Medicare and Medicaid Services, or CMS, suspended payments to Rural/Metro on September 6, 2016, after federal investigators found the company may have been engaging in fraud, according to the settlement agreement.
As of Jan. 5, more than $1.2 million in paid claims were being withheld by CMS, records show. The $650,000 restitution from Rural/Metro will be retained by the U.S. from that amount, under the terms of the settlement, and both parties have to pay their own legal costs.
The settlement agreement does not determine liability, Williams said.
“Ambulance transportation services are often necessary, and sometimes critical, for seniors and other Medicare beneficiaries,” Acting U.S. Attorney Karin Hoppmann said in a written statement. “We will continue to protect the integrity of our federal health care programs by ensuring that the services rendered, and billed for, are actually necessary and appropriate under the law.”
The Rural/Metro Corporation’s LinkedIn page calls the company a “national leader in private ambulance and fire protection services” serving over 450 communities across 20 states from its headquarters in Scottsdale, Ariz. The company claims to provide over a million ambulance transports and dispatches firefighters to over 60,000 calls per year.
Florida records list the business’ name as the Rural/Metro Corporation of Florida and show its principal address in Greenwood Village, Colo., a Denver suburb. The registered officers for the company live in Missouri, Texas and Colorado, records show.
A website for the company’s Central Florida office lists an Orlando address in the Malibu Groves neighborhood. An email listed as belonging to the division general manager was inactive, and nobody at the company’s number answered a call requesting comment.
According to Rural/Metro of Central Florida’s Facebook page, which contains no posts, the company has served Central Florida for over 27 years and operates in Orange, Osceola, Seminole and Sumter counties, including the cities of Orlando, Eatonville, Ocoee, Winter Garden and Windermere.
The case was investigated by Assistant U.S. Attorneys Jeremy R. Bloor and Kelley Howard-Allen with officials from the Office of Inspector General for the United States Department of Health and Human Services, Daniels said.