The owners and manager of an ambulance company based in Bucks County have been charged with Medicare fraud. The U.S. Attorney in Philadelphia charged the two brothers who own the company and their cousin, a company manager, on June 26. This makes the eighth ambulance company in the Philadelphia area to be indicted since 2011, with a total restitution of $20 million fined across the cases thus far.
The U.S. Attorney alleges that the ambulance company committed fraud by providing medically unnecessary ambulance services in order to collect Medicare payments. The five-ambulance firm received $1.2 million from Medicare in 2012. The firm allegedly offered Medicare beneficiaries kickbacks of up to $500 per month to continue using its ambulances while failing to collect required co-pays. The firm also reportedly would sometimes transport patients in cars rather than ambulances and would target patients who required regular trips to the hospital, such as kidney dialysis patients.
Anyone facing similar charges can face significant consequences under the federal False Claims Act. Each count of Medicare fraud is punishable by up to five years' imprisonment and a fine of up to $250,000. A felony conviction could also have negative impacts on the defendant's professional life. In this instance, it is unlikely that any of the defendants would be able to continue to work in the health care industry in the event of a conviction.
A criminal defense attorney could seek to arrange for a plea bargain with the prosecutor. A plea bargain might allow an accused individual to face reduced charges or reduced penalties. This might prove particularly attractive those who could potentially have to pay millions of dollars in fines or spend many years in prison.
Source: Association of American Physicians and Surgeons, "Criminal Prosecutions for Medicare and Medicaid Fraud," Mark L. Bennett Jr.
Source: Philly.com, "Ambulance officials charged in $1.9M Medicare fraud", Harold Brubaker, June 28, 2014