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Williston Rescue to pay $800,000 in false Medicare claims case

Justice Department announces action after ambulance transport probe

Wednesday, Feb. 27, 2013 7:11 AM
Last updated 7:35 PM
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BARNWELL, S.C. — Williston Rescue Squad Inc. has agreed to pay the U.S. $800,000 to resolve allegations it violated the federal False Claims Act in ambulance transports, the Justice Department announced this week.

Medicare reimburses providers only for nonemergency ambulance transports if the patient is bed-confined or has a medical condition that requires an ambulance. The settlement resolves allegations that the rescue squad billed Medicare for routine, nonemergency ambulance transports that were not medically necessary and created false documents to make the transports appear to meet the Medicare requirements.

Barnwell County Councilman Lowell Jowers said the settlement should not have any impact on Barnwell County doing business with the rescue squad.

Jowers said the squad’s “top three” management people had been replaced since the incidents occurred in 2008 to 2011.

Barnwell County contracts with Williston for nearly $1 million per year for emergency medical transports throughout the county. The contract is set to renew in June.

“Back in 2011, the government identified various billing concerns at the Williston Rescue Squad, which arose from claims submitted from the WRS Transport division from 2008 to 2011. These claims related primarily to the transport of dialysis patients,” rescue squad director Phil Clarke said in an e-mailed statement.

The settlement resolves a lawsuit filed by Sandra McKee under whistleblower provisions of the False Claims Act. McKee is a clinical social worker at a facility that regularly received patients transported by Williston’s ambulances. Under the False Claims Act, citizens can bring suit on behalf of the U.S. and share in any recovery. McKee will receive $160,000 as her share of the government’s recovery.

“Williston fully cooperated with the government, which resulted in a settlement agreement in which there was no admission of liability by Williston,” Clarke said. “However, to resolve the government’s concerns and to bring closure to the process, Williston agreed to make certain payments to the government.”

“Medicare fraud is stealing, and it is crippling America’s health care system, said Stuart F. Delery, the principal deputy assistant attorney general for the Civil Division, in a Monday news release.

Comments (5) Add comment
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Little Lamb
46025
Points
Little Lamb 02/27/13 - 09:12 am
4
2
Fraud

I saw this article in yesterday's print edition, and am glad they put it up on the web.

When the government creates subsidies for every little thing; when they encourage people to sign up for government benefits (food stamps, medicaid, electric & gas bill suppments, and a thousand other things) then you know someone will attempt to game the system — and succeed most of the time. Only a few get caught.

soapy_725
43678
Points
soapy_725 02/27/13 - 11:08 am
0
0
The odds of getting caught are so low.....
Unpublished

that Medicare Fraud is the number one source of income for organized crime. Florida being the top of the list of "good earners".

curly123053
4671
Points
curly123053 02/27/13 - 12:09 pm
3
0
Greed!

I would like to see some people go to jail over this fiasco. This was nothing but greed from the top. I had worked for Williston back before all this happened and know a lot of people down there. I know several people there who were putting in honest days of work for these crooked leaders who wound up laid off when this thing went down. Several people lost their jobs over this deal due to the greed. I feel like some people need to be going to the federal pen for what they did. They didn't just cheat the government, they hurt their own workers.

jimmymac
39881
Points
jimmymac 02/27/13 - 03:39 pm
3
3
The use of ambulances to
Unpublished

The use of ambulances to tranport people for non-emegency travel should be stopped immediately. No wonder medicare-medicade costs have sky rocketed. It's not taxpayers responsibilty to transport people to and from routine medical activities. I bet they don't have any problem getting to and from welfare offices.

palmetto1008
9782
Points
palmetto1008 02/28/13 - 09:26 am
1
1
Really, Little Lamb? Medical
Unpublished

Really, Little Lamb? Medical care is a "little" thing?
Society's efforts to help those who are in TRUE need should not be blamed for those who abuse the system....and that includes greedy and unscrupulous providers such as this one.

Young Fred
17465
Points
Young Fred 02/28/13 - 01:10 pm
1
0
LL is correct

LL’s point is valid. Where gov’t subsidies/programs are involved, people do attempt to cheat the system.

The problem Palmetto, is the system makes very little effort to identify and provide to only those in TRUE need. They tend to actively recruit those eligible whether they’re in TRUE need or not.

Many times bureaucrats actively help some game the system, knowing full well they aren't in TRUE need.

No, I don’t blame society for trying to help those in true need. I do blame government for purposeful wasting of money we can’t afford, for trying to continually grow itself, for inserting itself into every aspect of human life, for trying to make us all dependent on it!

palmetto1008
9782
Points
palmetto1008 02/28/13 - 01:56 pm
1
1
And, Young Fred, it's going
Unpublished

And, Young Fred, it's going to cost you more of your hard earned tax dollars to do more identification. Nonetheless, in this case, the culprits WERE identified.
Perhaps we should impose more public outrage at these providers who willingly, knowingly, and strategically scam the system and force them out of business....rather than arguing that just because a "system" exitsts, it deserves to be scammed.

Young Fred
17465
Points
Young Fred 02/28/13 - 02:26 pm
1
0
I missed the part where

I missed the part where somebody claimed "just because a system exists, it deserves to be scammed".

palmetto1008
9782
Points
palmetto1008 02/28/13 - 05:10 pm
0
0
Fred, it was very explicit in
Unpublished

Fred, it was very explicit in Little Lamb's comment at 8:12. It was more implicit in your last sentence at 12:18, though, perhaps, I misinterpreted.

Young Fred
17465
Points
Young Fred 03/01/13 - 02:02 am
0
0
Really?

I saw accurate observations.

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