Tampa ambulance company to pay $5.5 million in Medicare fraud lawsuit
Posted January 31, 2018 9:21 a.m. EST
TAMPA -- The city's largest ambulance provider will pay nearly $5.5 million to settle a lawsuit that accused the company of defrauding Medicare, the U.S. Attorney's Office said.
AmeriCare Ambulance Service Inc. and its sister company, AmeriCare ALS Inc., charged Medicare and the military health insurer Tricare for ambulance transports that were not medically necessary, according to a complaint filed by the government last year.
The recently appointed U.S. attorney for the Middle District of Florida, Maria Chapa Lopez, said this settlement showed her office will go after those who try to swindle the government.
"Fraudulently billing the government for medically unnecessary ambulance transports poses a heavy drain on the Treasury, deprives federal health care programs of valuable resources, and will not be tolerated," she said in a statement Tuesday.
AmeriCare, based in Seffner, committed the fraud from 2008 to 2016, according to the U.S. Attorney's Office. The company asked employees to lie on thousands of documents during those years so Medicare would pay, the government complaint said.
Ernest Sharp, a former paramedic at AmeriCare, first filed a lawsuit against the company under the False Claims Act, which allows a person to sue on behalf of the government.
Sharp worked for AmeriCare from October 2012 to February 2013, according to court documents. During that time, supervisors told Sharp to "word the reports in such a way that Medicare would pay the claims," he said in court documents.
Sharp was told to write that he placed patients in the ambulance by using a "soft stretcher" even if he hadn't, and to avoid using the word "ambulate" to describe patients, according to court documents. Writing reports this way would allow AmeriCare to charge Medicare for the transportation of the patient, court documents said.
A month before Sharp was fired, a manager was told to rewrite a report so that AmeriCare would get a Medicare reimbursement, but Sharp told her that doing so would be fraud, court documents said.
AmeriCare fired Sharp and accused him of taking company files and sabotaging the computer network. Sharp filed a suit against AmeriCare in 2013, according to court documents. The government took over the lawsuit in 2017.
Several AmeriCare workers and managers told government lawyers that filing false Medicare claims was a systemic practice within the company.
AmeriCare didn't respond to calls from the Tampa Bay Times. By settling, it's not admitting liability, according to the agreement it signed with the government.
AmeriCare has already paid $3.7 million to the government, most of which was returned to Medicare. The remaining $1.7 million will be paid over a five-year period with a 2.375 percent annual interest rate.
Sharp will get about $1.15 million of the total settlement.
The company also agreed to enter an integrity agreement with the Inspector General of the U.S. Department of Health and Human Services. The agreement will require the company to establish new standards that would prevent future fraud.