County Ambulance, Inc. Agrees to Pay $16,776.74 to Settle Civil Health Care Fraud Case
Portland, Maine: United States Attorney Halsey B. Frank today announced that County Ambulance, Inc. (“County Ambulance”), of Ellsworth, has entered into a civil settlement agreement with the United States and the State of Maine in which it will pay $16,776.74 to resolve allegations that it submitted false claims to Medicare and MaineCare (Maine’s Medicaid program) from January 2015 through April 2016. MaineCare is primarily funded by the United States, which pays about two-thirds of all claims submitted to MaineCare.
According to a civil complaint filed today, County Ambulance used money paid to it by Medicare and MaineCare to pay the salary and benefits of a County Ambulance employee who previously had been excluded from Federal health care and the MaineCare programs. Federal health care programs may not pay for items or services furnished, ordered, or prescribed by excluded individuals or entities, including administrative and management services or salary. Prior to joining County Ambulance, the employee had been excluded after surrendering her license to practice as a pharmacy technician due to the diversion of controlled substances, but County Ambulance failed to check publicly available exclusion databases to determine if she was excluded. County Ambulance cooperated throughout the investigation.
The case was investigated by the U.S. Department of Health & Human Services, Office of Inspector General, and the Attorney General’s Office of the State of Maine. The civil action is docketed United States and the State of Maine v. County Ambulance Service, Inc., d/b/a County Ambulance, Inc., 1:18-cv-00280-JAW (D. Me.).