From the U.S. Attorneys Office in Baltimore:
After a multiple-year investigation and the government’s intervention in a whistleblower lawsuit, Hart to Heart Ambulance Services, d/b/a/ Hart to Heart Transportation Services has agreed to pay the United States $1,250,000 to settle allegations under the False Claims Act that it submitted false claims to Medicare for ambulance transport that was not medically necessary.
The settlement agreement was announced today by United States Attorney for the District of Maryland Robert K. Hur and Special Agent in Charge of the Office of Inspector General for the Department of Health and Human Services, Maureen Dixon.
“Companies that submit false bills to the government must be held accountable. The United States Attorney’s Office is committed to taking the steps necessary to protect Medicare and other federal healthcare programs from fraud and abuse and recover taxpayers’ money,” said U.S. Attorney Robert K. Hur.
“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 Maureen Dixon, 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.”
On November 30, 2018, the United States filed a complaint in U.S. District Court alleging that Hart to Heart, its billing affiliate, EMS Billing Solutions, Inc. (“EMS”), and the owners and operators of those organizations violated the False Claims Act by submitting or causing the submission of false claims to Medicare for ambulance transport that was not medically necessary, and for which the defendants received millions of taxpayer dollars. Medically necessary ambulance transportation requires that a patient’s medical condition is such that other methods of transportation are contraindicated, but Hart to Heart submitted a high rate of ambulance claims for patients who could have been transported by wheelchair van or other means. The complaint cites accounts from numerous former Hart to Heart employees about management’s pressure and directions to falsify documentation to make Medicare reimbursement more likely.
In reaching this settlement, the parties have resolved allegations that, from January 2, 2010 to December 31, 2017, Hart to Heart knowingly submitted fraudulent claims to Medicare for non-emergency Basic Life Support (BLS) ambulance transports hospital discharges that were not medically necessary.
The claims resolved by this settlement are allegations. The settlement is not an admission of liability by Hart to Heart Transportation Services or its affiliates, nor a concession by the United States that its claims are not well founded.
The government’s action in this matter illustrates its commitment to combat health care fraud using 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).
Bryan Arvey, a former Hart to Heart employee, originally filed this lawsuit under the qui tam, or whistleblower, provisions of the False Claims Act, which permits private individuals with knowledge of fraud to sue on behalf of the government for false claims and to share in any recovery. Mr. Arvey will receive approximately $251,000 from the settlement with Hart to Heart. The case is captioned United States, et al. ex rel. Arvey v. Hart to Heart Transportation Services, Inc. et al., Case No. RDB-13-1554.
United States Attorney Robert K. Hur commended the U.S. Department of Health and Human Services – Office of Inspector General for its work in the investigation. Mr. Hur also thanked Assistant United States Attorneys Roann Nichols and Molissa Farber, who handled the case.