Ambulance Company Owners Agree to Pay More Than $245,000 to Resolve Kickback Allegations
HOUSTON – The former owner and operator of Houston-area ambulance company National Care EMS has agreed to settle allegations that he and the company provided kickbacks to various nursing facilities and hospitals in exchange for rights to the institutions’ more lucrative Medicare and Medicaid transport referrals, announced U.S. Attorney Kenneth Magidson along with Gregory Demske, Chief Counsel to the Inspector General of the U.S. Department of Health and Human Services - Office of Inspector General (HHS-OIG) and Special Agent in Charge CJ Porter, of HHS-OIG, Office of Investigations - Dallas Regional Office.
Mohammed Elsaleh, 27, of Sugar Land, formerly owned National Care EMS, which is no longer in business. The settlement calls for Elsaleh to pay $125,000 to resolve the “swapping” allegations made against him and the company. In addition, Elsaleh’s brother, Husam Alsaleh, 29, also of Sugar Land, the owner and operator of a successor company also called National Care EMS has agreed to pay $120,000, plus interest, in furtherance of the settlement.
“This settlement send a message that any alleged kickback or improper relationship among providers will not be tolerated,” said Magidson. “We will continue to hold those accountable that attempt to detrimentally impact the integrity of our health care system.”
The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by federal health care programs, including Medicare and Medicaid. The settlement announced today resolves allegations that Elsaleh and National Care EMS provided free and heavily discounted ambulance transports to various nursing facilities and hospitals in exchange for the institutions’ referral of other lucrative Medicare and Medicaid business to National Care EMS.
“This settlement sends a message to the health care industry that both sides of a swapping arrangement can be held responsible for their improper actions, not just the entity that actually bills Medicare or Medicaid for the services,” said Demske. “Any company or individual considering entering such schemes should understand that their actions may have serious legal and financial consequences.”
Medicaid is funded jointly by the states and the federal government. The state of Texas paid for some of the Medicaid claims at issue and will receive approximately $21,000 of the settlement amount.
“The Office of Investigations will continue to pursue all parties in improper swapping arrangements to insure legitimacy in health care expenditures across all service areas, including ambulance transports,” said Porter.
Today’s announcement also marks another achievement for the Health Care Fraud Prevention and Enforcement Action Team initiative, which was announced in May 2009 by the Attorney General and the Secretary of Health and Human Services. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid financial fraud through enhanced cooperation.
The settlement was the result of a coordinated effort among the U.S. Attorney’s Office, HHS-OIG, HHS-OIG (Office of Counsel to the Inspector General) and the Texas Attorney General’s Office. Assistant U.S. Attorney Kenneth Shaitelman handled the case on behalf of the U.S. Attorney’s Office for the Southern District of Texas.
The claims resolved by this settlement are allegations only, and there has been no determination of liability.