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Justice News

Department of Justice
U.S. Attorney’s Office
District of Rhode Island

FOR IMMEDIATE RELEASE
Friday, December 21, 2018

Settlement Agreement Announced in Medicare and Medicaid Investigation

PROVIDENCE – Professional Ambulance, LLC, a local provider of ambulance and medical transportation services based in Providence, will pay $300,000 to resolve allegations that it improperly billed the Medicare and Medicaid programs for medically unnecessary ambulance runs, according to a Civil Settlement Agreement signed today.

An investigation by the United States Attorney’s Office, the U.S. Department of Health and Human Services - Office of Inspector General (HHS-OIG), and the FBI determined that between 2012 and 2015, Professional Ambulance billed the Medicare and Medicaid programs for the cost of transporting patients who were not eligible to travel by ambulance because they were sufficiently mobile. The investigation specifically focused on dialysis patients, who require regular trips to and from a treatment facility to receive care, but who, the United States alleged, did not require ambulance transport, or whose condition was not accurately documented in reports.

Today’s settlement resolves claims by the United States and the State of Rhode Island under the federal and state False Claims Acts, as well as various other civil theories of liability.  $250,000 of the recovery will go to the federal government on behalf of the Medicare program; the remaining $50,000 will be returned to Medicaid, which is jointly administered by the federal government and the State of Rhode Island.  The matter was settled prior to litigation, without an admission of liability or wrongdoing.

The settlement agreement is announced by United States Attorney Stephen G. Dambruch, Phillip Coyne, Special Agent in Charge of HHS-OIG - New England Region, and Special Agent in Charge of the Boston Division of the FBI Harold H. Shaw.

The case was handled by Assistant U.S. Attorney Zachary A. Cunha.

United States Attorney Stephen G. Dambruch acknowledges and thanks the Rhode Island Department of Attorney General’s Medicaid Fraud Control and Patient Abuse Unit for their assistance in the investigation of this matter.

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Topic(s): 
Health Care Fraud
Contact: 
Jim Martin (401) 709-5357
Press Release Number: 
18-172
Updated December 21, 2018