If your employer is submitting false claims to Medicare or Medicaid, you have a stark choice. You can become a whistleblower and earn a substantial reward by helping the government stop the fraud, or you can go along with your employer and face serious prison time when your employer finally gets caught.
An EMT and ambulance driver in Philadelphia learned this the hard way when they were convicted on charges of conspiracy to commit health care fraud and making false statements to the government. They now face up to 15 years in prison and a $500,000 fine each when they are sentenced.
According to the government, Brotherly Love Ambulance, Inc. submitted false claims to Medicare and Medicaid for ambulance transports that were not medically necessary and were not provided in ambulances with the required lifesaving equipment.
In addition to prosecuting the owner of the ambulance company, the government also prosecuted the Emergency Medical Technician (EMT) and ambulance driver who prepared the “run sheets” for the ambulance transports. EMT Fritzroy Brown and ambulance driver Thael Kuran were convicted of signing false run sheets or trip reports that the ambulance company used to support its claims to Medicare and Medicaid.
According to the government, the run sheets misstated the patients’ medical conditions by failing to disclose that the patients were able to walk. Under Medicare and Medicaid regulations, patients who are not bed confined and are able to walk are not eligible for ambulance transport reimbursement. They must be transported in less expensive medical vans.
The run sheets also indicated that the patients were always transported in ambulances when, in fact, they were sometimes transported in vans that lacked the lifesaving equipment required for ambulance transports. The ambulance company used these false run reports to bill Medicare and Medicaid for more expensive ambulance transports.
The EMT and ambulance driver in this case could have made a much better choice. If they had consulted with a whistleblower lawyer, they could have earned a large financial reward and most likely avoided any criminal charges.
Under the False Claims Act, an individual with evidence of false claims to Medicare or Medicaid can file a lawsuit “under seal” (that is, in secret) and present their evidence to the government. If the government recovers money as a result of the lawsuit, the whistleblower is entitled to a reward of between 15% and 30% of the amount recovered.
If you have evidence that your employer is submitting false claims to Medicare or Medicaid, do not go to prison for them. Contact an experienced whistleblower lawyer and find out if you are eligible for a substantial financial reward and legal protections as a whistleblower.
To schedule a free and confidential consultation, call John Howley, Esq. at (212) 601-2728.
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