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.