The former billing manager for MedStar Ambulance, Inc. will receive a $3.5 million whistleblower reward for reporting overbilling at the ambulance company.
MedStar has agreed to pay $12.7 million to settle the whistleblower’s claims that it billed Medicare for unnecessary ambulance services. The whistleblower’s complaint alleged that the company billed Medicare for ambulance services that were not medically necessary, that were billed at higher levels of services than patients’ conditions required, and that were billed at higher levels of services than were actually provided.
One of the schemes involved billing Medicare for routine trips to a doctor’s appointment or nursing home as if they were emergency runs in order to receive higher Medicare reimbursements. The whistleblower also reported that the company double-billed patients and Medicare, and that it billed Medicare when it should have billed hospitals or municipalities.
The whistleblower brought his claims under the qui tam provisions of the False Claims Act. He filed a complaint “under seal” (i.e., in secret) in federal court and handed over all of his evidence to the U.S. Attorney. The government then used his evidence to conduct an investigation and pursue claims against the company.
The False Claims Act provides that a whistleblower is entitled to a reward of between 15% and 30% of the amount the government actually recovers. In this case, the whistleblower will receive $3.5 million, or approximately 28% of the government’s recovery.
If you have evidence of overbilling or false claims submitted to Medicare or Medicaid, then you should consult with an experienced whistleblower lawyer immediately to protect your rights. There are strict time limits and procedural requirements to preserve your claim.
Call John Howley, Esq. at (212) 601-2728 to schedule a free and confidential consultation.