Lawyers from Berger & Montague, P.C. and Wenzel Fenton Cabassa, P.A. successfully represented an AmeriCare Ambulance Service worker in a False Claims settlement. The suit alleged that AmeriCare and a sister company defrauded the government by billing Medicare for thousands of medically unnecessary services.
AmeriCare provides ambulance transportation services most commonly to Medicare beneficiaries. Medicare only covers ambulance transportation services when other methods of transportation (such as a non-ambulance stretcher van or a car) would endanger a patient’s health. The firms’ client worked as a paramedic at AmeriCare and discovered the alleged fraud during his employment.
The client alleged that AmeriCare routinely asked him to falsify records to misrepresent the medical condition of patients to create the false impression that the services were medically necessary. When he expressed concerns about this to AmeriCare management, he was fired. The client then filed claims under the False Claims Act.
In addition to paying approximately $5.5 million, AmeriCare has also agreed to enter into an integrity agreement with the Inspector General of the U.S. Department of Health and Human Services.
“We worked very hard on this case since the time it was filed in 2013 — the team earned this outstanding result,” said Berger & Montague shareholder Shauna Itri, counsel for the whistleblower. “We want whistleblowers to be proud about their actions, and we believe the settlement is something our client can be proud of.”
Wenzel Fenton Cabassa partner Steven G. Wenzel added: “The United States faces a crisis because of the rising cost of healthcare. Fraud must stop — it hurts patients who won’t be able to get care. All healthcare workers should be vigilant about their employer’s misdeeds and call us so we can help stop fraud and protect their job rights.”
Settled on Jan. 30, the case is United States ex rel. Sharpe v. AmeriCare Ambulance Service, No. 8:13-cv-01171 (M.D. Fla. 2013).