Ambulance Fraud Defense
Houston Ambulance Fraud Lawyers :: The Law Office of Matthew D. Sharp
Ambulance fraud is costing taxpayers millions of dollars every year. When an ambulance company engages in emergency medical services fraud by improperly billing the government for services that violate Medicare’s billing standards, everyone else has to pay the bill. Federal whistleblower laws allow private citizens to receive substantial rewards for uncovering acts of fraud related to Medicare. If you or the company you work for is facing EMS fraud accusations, get in touch with a Houston ambulance fraud attorney.
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Emergency Medical Services Fraud
There are two essential criteria that must be met to satisfy the federal government’s “medically necessary” guidelines for ambulance transport. The two vital standards are as follows:
- The use of another form of transportation was contraindicated by the patient’s medical condition
- The services provided and billed were warranted by the patient’s medical condition
Emergency medical services that fail to meet these criteria are not billable to Medicare. Knowingly billing the federal government for fraudulent medical services constitutes a violation of the False Claims Act. Among the most common kinds of ambulance fraud and false Medicare claims are the following:
- Billing for medically unnecessary dialysis transportation
- Billing for the provision of patient transportation to routine medical appointments such as radiology or radiation treatment
- Upcoding a billable EMS service to a more expensive service
- Billing Medicare for services or supplies that were never actually provided
- Entering into illegal contractual relationships with medical providers in violation of the Anti-Kickback Statute
Medicare Fraud Whistleblowers
An increasing number of ambulance companies have been fined for improperly billing Medicare for services that were never provided or were medically unnecessary. Whistleblowers who have knowledge of and reveal EMS fraud have been paid millions of dollars in rewards by the federal government.
A qui tam lawsuit allows an informant to earn a portion of the fines that Uncle Sam collects from a guilty ambulance company.
EMS Fraud Penalties
In a 2006 qui tam case, American Medical Response was penalized $9 million, and the whistleblower’s reward was a hefty $1.6 million. And in 2004, Adventist Health was hit with a $20 million punishment. The informant in that case received $2.4 million for safeguarding the interests of the public.
Meet With an Ambulance Fraud Lawyer in Houston, TX
When a company is accused of deceiving or cheating Medicare, it is normal to feel confused and helpless, since the potential penalty for this crime may consist of not just hundreds or thousands of dollars, but millions of dollars. However, there is hope. An emergency medical services fraud attorney like the ones at The Law Office of Matthew D. Sharp will help defend your legal rights. For a free consultation, contact The Law Office of Matthew D. Sharp today.