A year ago, a blog post from prominent New York City trial lawyer John Howley caused quite a stir in the EMS community.
We’ve written extensively on Medicare fraud in the transportation industry here on our blog, but this one was surprising even for us.
Back in May, the New York City Fire Department joined a long list of entities (hospitals, ambulance companies and other organizations) that have settled or been prosecuted for violating the False Claims Act and defrauding the federal health care system.
Last month we wrote an article here on our blog explaining how ambulance companies commit Medicare fraud. It outlined the different schemes that some non-emergency companies pull---and what CMS is doing to try to stop them.
After it went live, we received a ton of feedback from medical professionals around the country. More than 28,000 visitors viewed the post --- and it clearly struck a chord. Many readers (especially EMS workers) mentioned that they had personally witnessed some of the schemes mentioned in the post.
Others pointed out a different but related issue --- that discharge personnel at hospitals and skilled nursing facilities that arrange transportation services for patients are often unknowingly contributing to this type of fraud. We thought it would be a good idea to write a follow-up post looking into some of these claims.
While every industry has its fraud, unfortunately the non-emergency ambulance transportation world is especially plagued with shady practices. According to the Centers for Medicaid and Medicare Services, every year $350 million is ripped off by ambulance companies.
But not all ambulance companies are committing Medicare fraud. There are many providers that play by the rules and should therefore be applauded. This article is not about them. This article explains what the rules are, and how certain companies are systematically skirting them.