Primary Care Physicians to Pay $1.5 Million to Resolve False Claims Act Liability for Submitting Unsupported Diagnoses to the Medicare Advantage Program
PHILADELPHIA – Thael Kuran, 24, of Philadelphia, PA, was sentenced today to 37 months in prison for a health care fraud scheme involving Brotherly Love Ambulance, Inc. In addition to the prison term, U.S. District Court Judge Gerald J. Pappert ordered three years of supervised release, restitution in the amount of $2,015,712.52, and a $200 special assessment.
Through Brotherly Love, Kuran transported patients who were able to walk and could travel safely by means other than ambulance and who, therefore, were not eligible for ambulance transportation under Medicare requirements. Kuran and other conspirators falsified reports to make it appear that the patients needed to be transported by ambulance when he knew that the patients could be safely transported by other means and, in fact, many of them could walk. In addition, Kuran and other conspirators paid kickbacks to patients to ensure that they would use Brotherly Love Ambulance for services which were not medically necessary. The company also billed Medicare for ambulance services for patients who were not transported by ambulance, but whom Kuran and others transported in personal vehicles. Kuran and others completed documentation of these transports that made it appear that the patients had been transported in an ambulance and that misrepresented the medical care provided to and safety precautions taken for these patients. As a result of the fraudulent scheme at Brotherly Love, the Medicare program paid more than $2 million for fraudulent claims from Brotherly Love.
The case was investigated by the U.S. Department of Health and Human Services Office of the Inspector General, the Federal Bureau of Investigation, and the U.S. Department of Labor Office of the Inspector General. It is being prosecuted by Assistant United States Attorneys Mary E. Crawley and Paul W. Kaufman.