Ambulance Fraud Allegations Result in Multiple Felony Charges

The owner of a medical transportation company has been indicted on seven counts of health care fraud.  The government alleges that he defrauded Medicaid of $406,000 by filing false claims on behalf of his ambulette company.

This is the latest in a growing number of ambulance fraud investigations and criminal prosecutions.

Rolando Sepulveda owned and operated Med Transportation, a company that provided ambulette transportation services for Medicaid beneficiaries.  An ambulette is a specially equipped van designed to transport passengers in wheelchairs.

Medicaid pays ambulette companies to transport Medicaid patients to and from Medicaid-covered appointments.  To qualify for ambulette transportation reimbursement, the following criteria must be met:

• the patient must ride in a wheelchair
• a medical doctor must certify the need for the wheelchair and ambulette
• the ambulette must meet Medicaid’s safety specifications.

Sepulveda is accused of filing false claims with Medicaid for transporting patients who did not need or use wheelchairs.  He is also accused of fraudulently billing Medicaid for ambulette attendants, when his company did not provide attendants on the ambulettes.

Submitting claims to Medicaid for services that were not medically necessary or were not provided violates the federal False Claims Act and other state and federal laws.

The government’s press release notes that the defendant “is currently believed to be residing in Puerto Rico.”  This absence may explain why the government sought an indictment on seven felony charges, which could result in a long prison sentence. 

When you are facing a Medicaid fraud investigation, it is important to get advice from an experienced Medicaid fraud attorney immediately, before you talk to anyone fro, the government.  Your lawyer may be able to negotiate a financial settlement that avoids an indictment.  But if the government cannot find you, then they will charge you with the most serious crimes.

Employees also need advice from a Medicaid fraud attorney if they are aware that their employer is submitting false claims to Medicare or Medicaid.  When the government suspects that a company is engaged in Medicare and Medicaid fraud, it investigates everyone connected with the company.  You could be at risk even though you are not personally benefiting from the fraud.  If you are aware of false or fraudulent claims submitted to Medicare or Medicaid, you should consult with an experienced Medicaid and Medicare fraud lawyer immediately to protect yourself.  You may be entitled to legal protections and a substantial whistleblower reward under the federal False Claims Act.

To arrange a free and confidential consultation with an experienced Medicaid and Medicare fraud lawyer, call John Howley, Esq. at (212) 601-2728 or click here to reach our office via email.

John Howley, Esq.

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