Medstar Ambulance, Inc., and its related entities, have agreed to pay the United States government $12.7 million to resolve allegations made by a whistleblower that the company defrauded taxpayers by submitting false and fictitious claims for Medicare reimbursement.
The case was originally brought to the government’s attention by a whistleblower who was a former employee in Medstar’s billing office. The employee became aware that the company had been defrauding Medicare by submitting bills for services that did not qualify for reimbursement because the ambulance transportation was not medically reasonable or necessary and that the company billed for services that were either not required or not actually provided.
The whistleblower who filed this False Claims Act case will receive approximately $3.5 million dollars as a whistleblower reward. The False Claims Act rewards whistleblowers who report fraud to the government in healthcare programs like Medicare, as well as other government contracts and services. Typically, a whistleblower will receive between 15-30% of the total amount collected by the government. Like many whistleblower claims, this particular complaint was filed by a former employee who was intimately aware of the fraud in which the company had been engaged for several years.
Our firm has recently reviewed a number of cases involving healthcare providers, like ambulance services, that perform services that are not medically required in order to receive a financial payment from the government. Billing fraud is unfortunately common in the healthcare industry, and we have seen at least one other very similar case where an ambulance company is billing Medicare for services that were not medically necessary.
If you are aware of a hospital, physician, or other health care provider who is defrauding the government by submitting bills for services that are not medically appropriate or necessary, or billing for services that are not actually provided to patients, you may have the ability to report this fraud to the government by filing a whistleblower complaint. A well-researched and properly filed complaint may result in the whistleblower receiving a substantial financial reward.
Our whistleblower attorneys have represented many whistleblowers in billing fraud cases and we are always available to answer any questions about the False Claims Act complaint process. We always provide a free and completely confidential consultation for someone who thinks they may be aware of a company defrauding the federal government and may be interested in pursuing a whistleblower reward.