United States Obtains More Than $370 Million In Judgments Against Kentucky Businessman And His Companies For Laboratory Testing Scheme That Targeted Medicare
Jacksonville, FL – Today, after a multiple-year investigation and the government’s intervention into a whistleblower suit in 2015, the United States announces a $1.2 million settlement with Liberty Ambulance. In reaching this settlement, the parties have resolved allegations that, from June 29, 2005, to January 2016, Liberty Ambulance knowingly up-coded claims for life support services from “Basic” to “Advanced” without justification, unnecessarily transported patients, and unnecessarily transported patients to their homes in an emergent fashion.
“The United States Attorney’s Office is committed to taking the steps necessary to protect Medicare, TRICARE, and other federal healthcare programs from fraud and abuse,” said U.S. Attorney Maria Chapa Lopez. “Whenever founded, our Office will vigorously pursue these cases and recover taxpayers’ money.”
“When health care providers participate in fraudulent billing schemes in order to increase profits, they steal from the pockets of the taxpayer and jeopardize federal healthcare programs,” said Shimon Richmond, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “We will continue to be relentless in our efforts to hold such providers accountable.”
“This settlement highlights the commitment of the Defense Criminal Investigative Service (DCIS) and its law enforcement partners to protect the integrity of the Department of Defense (DoD) health care program,” said Special Agent in Charge John F. Khin, Southeast Field Office. “DCIS aggressively investigates health care providers that defraud the DoD, to preserve American taxpayer dollars intended to care for our Warfighters, their family members, and military retirees.”
Today’s settlement involved false claims submitted to Medicare, TRICARE, Medicaid, and the Federal Employees Health Benefits Program managed by the Office of Personnel Management. The claims resolved by this settlement are allegations only, and there has been no determination of liability. This case was initiated by the filing of a qui tam lawsuit filed by Shawn Pelletier, a former employee of Liberty Ambulance. Mr. Pelletier collected more than $1.2 million in proceeds from prior settlements, and will receive approximately $264,000 from the present settlement with Liberty.
The government’s action in this matter illustrates its emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).
This case was investigated by the Federal Bureau of Investigation, the Office of Personnel Management, the Defense Criminal Investigative Service, the U.S. Department of Health and Human Services - Office of Counsel to the Inspector General, the U.S. Department of Health and Human Services - Office of Inspector General, Office of Audit Services, the Florida Medicaid Fraud Control Unit, and the Defense Health Agency Program Integrity Office. It was handled by Assistant United States Attorney Shea Gibbons.