A settlement has been reached to resolve False Claims Act allegations against AmeriCare Ambulance Service.
The allegations arose from a lawsuit that claimed AmeriCare Ambulance Service Inc and its sister company, AmeriCare ALS Inc (collectively, AmeriCare) defrauded Medicare by billing for medically unnecessary ambulance transportation services.
According to the governement, from January 2008 through December 2016, AmeriCare allegedly submitted fraudulent claims to Medicare and TRICARE for Basic Life Support (BLS), non-emergency ambulance transports that were not medically justified. In support of these allegations, the government cited information regarding unwarranted ambulance transports it had received from numerous AmeriCare employees, as well as audits conducted by the agencies that administer Medicare and TRICARE.
In addition, the government cited damaging testimony it had elicited under oath from members of AmeriCare’s management team during the course of the investigation. This testimony, along with the other evidence obtained by the government, revealed that AmeriCare had engaged in a systemic practice over many years of submitting fraudulent claims to the government falsely attesting to the medical necessity of its non-emergent, BLS ambulance transports. That proof also revealed that AmeriCare had created thousands of false reports and other documentation during this time period, in a failed effort to support this illicit practice.
Reportedly, AmeriCare has also agreed to enter into an integrity agreement with the Inspector General of the U.S. Department of Health and Human Services.
“Medical service providers who engage in systemic fraud at the core of their business levy an assault on federal health care programs and the American taxpayer,” said Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services, Office of Inspector General. “In spite of often false medical documents, the OIG and our partners will not be deterred in our efforts to root out this type of fraud and protect the American public.”
The whistleblower, a former AmeriCare employee, Ernest Sharpshare, will receive $1.15 million as part of the settlement.
