False claims submitted for ambulance services, multiple states

The U.S. Attorney's Office alleges false claims were submitted for ambulance services in multiple states, including Kentucky.

The U.S. Attorney's Office for the Western District of Kentucky has filed a civil complaint in U.S. District Court against Rural/Metro of Corporation, Rural/Metro of Central Alabama, Inc. and Mercury Ambulance Service, Inc., doing business as Rural/Metro Ambulance.

The plaintiff alleges that the ambulance services created and submitted false and fraudulent records and claims for payment by governmental healthcare providers.

Rural Metro Corp. through its subsidiaries and affiliates, provides ambulance transportation services to Medicare and Medicaid beneficiaries in approximately 20 states including Kentucky.

According to the complaint, the ambulance services falsely represented that transported patients were bed-confined or that transportation by ambulance was otherwise medically required.

However, many of those patients were not confined to bed and did not qualify for ambulance transport for other medical reasons under the applicable Medicare or Medicaid regulations, according to U.S. Attorney David J. Hale, Western District of Kentucky.

"Although the U.S. Attorney's Office for the Western District of Ky. led an extensive investigation of conduct occurring in Ky., we are comfortable that the U.S. Attorney's Office for the Northern District of Alabama will aggressively pursue the recovery of any Medicare and Medicaid funds obtained through fraudulent billing," said Hale.

With this complaint, the U.S. partially intervenes in a lawsuit that began as a federal whistle blower action against the defendants in September 2009 brought by Carl Crawly, a former employee of Rural/Metro of Central Alabama, Inc.

The lawsuit was filed under the provisions of the False Claims Act, which permits private parties to sue on behalf of the U.S. when they believe that defendants submitted false claims for government funds, according to Hale.

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