According to a suit filed by the US federal government, Century Ambulance and Liberty Ambulance allegedly collaborated with four area hospitals to transport Medicare and Medicaid patients lacking true medical need, in Jacksonville, Florida. The patients all ended up at one of four regional hospitals: Orange Park Medical Center, UF Health Jacksonville, Memorial Hospital and Baptist Medical Center Jacksonville, landing those institutions in hot water as well. The suit strongly suggests the ambulance companies fraudulently claimed more than 15 million dollars for those misrepresented patients.
The case sailed along to the settlement stage with help from key witness, EMT Shawn Pelletier. The witness testified about witnessing document falsification when billing US government controlled insurance programs. Pelletier will collect a portion of the lawsuit settlement payment for his participation as a whistleblower for this case.
Of course, the ambulance companies and hospitals all deny purposefully filing fraudulent claims in an effort to collect more money. In fact, the named institutions and companies decry the need for the lawsuit settlement cases at all. The operating managers blame a lack of adequate employee training in addition to the complexities of Medicare and Medicaid filing rules for the discrepancies. The companies intend to rectify the problem through increased training and alternative transportation options for stable patients.
Until the lawyers working for both sides finalize the written up settlement agreement, the case continues to sit in limbo for the time being. In the meantime, the government filed a second lawsuit against Liberty Ambulance for additional claims found during the discovery period of the trial. The settlements only seek to collect the money wrongfully taken from the government’s insurance accounts. Unless the lawyers can prove criminal wrongdoing by the responsible parties’, the case will not result in felony fraud charges for all of those involved.
The companies’ deemed responsible for the fraudulent claims must repay the total listed amount by the given date or face further repercussions. The judge will assign the terms of the lawsuit settlement payment upon giving the final order on the case. For the foreseeable future, all further claims from these companies, and related claims from un-involved entities, will be under intense scrutiny by all US government insurance representatives.