Fla. Provider Hammered for False Medicare Claims

Fla. Provider Hammered for False Medicare Claims

News Jan 30, 2018

A major Florida ambulance provider will pay around $5.5 million over charges it defrauded Medicare by billing for ambulance transports that weren't medically necessary. 

AmeriCare—consisting of AmeriCare Ambulance Service, Inc., and its sister company, AmeriCare ALS—is the largest provider in the Tampa area. 

“Fraudulently billing the government for medically unnecessary ambulance transports poses a heavy drain on the treasury, deprives federal healthcare programs of valuable resources, and will not be tolerated,” U.S. Attorney Maria Chapa Lopez said in announcing the agreement. “This lawsuit and today’s settlement evidence our office’s ongoing efforts to safeguard federal healthcare program beneficiaries from the effects of this type of unlawful conduct.”

From January 2008 through December 2016, according to a government complaint, AmeriCare submitted false claims to Medicare and the military insurance program Tricare for nonemergency BLS ambulance transports that weren’t medically justified. The case began when a whistleblower, former AmeriCare employee Ernest Sharp, sued under the False Claims Act; that law permits whistleblowers to share in recovered funds, and Sharp will receive about $1.15 million, according to the U.S. Attorney’s office. 

The government collected additional information from “numerous” AmeriCare employees and bolstered its case with audits by the agencies administering Medicare and Tricare. Testimony by AmeriCare leaders revealed “a systemic practice—over many years—of submitting fraudulent claims,” with thousands of false reports and other documentation. 

AmeriCare also agreed to enter into an integrity agreement with the HHS Inspector General. 

Tips from all sources about potential Medicare fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS. For more: https://www.justice.gov/usao-mdfl/pr/tampa-s-largest-ambulance-providers-agree-pay-55-million-resolve-false-claims-act

Source
U.S. Attorney's Office, Middle District of Florida
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