Medicare’s regulations cover the reimbursement of ambulance services only if the beneficiary’s medical condition dictates that other means of transportation are not advised.
These allegations recently surfaced in a successful False Claims Act qui tam action against a medical transport corporation operating in several states, including Alabama and Kentucky. In this case, Rural/Metro Corporation paid $5,426,000 to the federal government in settlement of allegations contained in a Medicare fraud qui tam lawsuit. According to the complaint, from January 2008 through August 2011, Rural/Metro sought reimbursement for non-emergency transportation for Medicare beneficiaries to receive dialysis services.
The qui tam relator was a former Rural/Metro emergency medical technician who viewed the alleged fraud firsthand. The relator received an award of $1,030,940 plus attorneys’ fees and costs.
More information for whistleblowers is located at the Nolan & Auerbach, P.A. website.