Former Employee Claimed Company Falsified Bills for Ambulance Services to Fraudulently Qualify for Higher Medicare Reimbursements in Violation of the False Claims Act
BOSTON – January 13, 2017 – Newman & Shapiro, a law firm dedicated to representing whistleblowers nationwide, today announced that MedStar Ambulance, Inc. and its related companies have agreed to pay $12.7 million to settle a False Claims Act lawsuit alleging the company fraudulently billed Medicare for unqualified ambulance services.
The whistleblower, former billing manager Dale Meehan, represented by Attorney Jeffrey Newman Esq. of Boston, alleged MedStar knowingly and fraudulently billed Medicare for ambulance services by billing for ambulance transports that were not medically necessary and by up-coding the runs to exact higher payments from the government.
“This was a case in which the evidence obtained in the 3-year litigation was clear in that it showed that the MedStar companies fraudulently over-billed Medicare and added false information to the ambulance run documents to make them Medicare eligible when they otherwise would not have qualified for reimbursement,” said Attorney Newman.
Meehan brought the case forward in 2013, after claiming she was fired for her continued questions and attempts to correct the fraudulent billing. She will receive $3,556,000 of the settlement under the federal False Claims Act, which allows whistleblowers to sue companies that are defrauding the government and receive a reward if the government recovers any funds as a result.
“This is not a case arising from the speculation of a disgruntled employee as has been publicly suggested in the past,” added Newman. “Dale Meehan courageously came forward and told the truth about this multi-million-dollar fraud scheme to make more profits. The Medicare system is already severely over-taxed at a time when every penny should be used for those who need it. Our nation should have no tolerance for this kind of fraud or deceit and it is our hope that the new administration will support and encourage individuals who come forward to report specific these kinds of fraud as Dale Meehan did.”
As part of the settlement, MedStar must also enter into a Corporate Integrity Agreement (CIA) with the Office of the Investigator General (OIG). OIG negotiates CIAs with health care providers and other entities as part of the settlement of Federal health care program investigations arising under a variety of civil false claims statutes. A comprehensive CIA typically lasts 5 years and includes requirements such as implementing employee training, hiring a compliance officer and providing annual status reports to the OIG.
The case was filed on October 4, 2013 in the Federal District Court of Massachusetts under the caption United States ex rel. Dale Meehan v. MedStar et als, Civil Action No. 13-12495-IT.
About Newman & Shapiro
Newman & Shapiro is a law firm dedicated to the representation whistleblowers nationwide in False Claims Act (or “qui tam”) litigation involving fraud against the government. This unique law allows private citizens with primary information about fraud on the federal and state governments to file actions on their behalf in return for which in successful claims they may receive a percentage of the recoveries. Founded by Jeffrey A. Newman Esq, the firm has a consistent track record of winning landmark, multi-million dollar settlements in cases involving Medicare, Medicaid, Pharmaceutical and healthcare fraud as well as other SEC and IRS whistleblower actions. In 2016 alone, the firm settled three cases amounting to over $165 million in recoveries to the government.