The United States Department of Health and Human Services has revealed new data showing that Medicare overpaid ambulance providers by $314 million last year and over a third of that was for unnecessary claims for the elderly and disabled., with rides to dialysis centers and doctors offices. Approximately one third of ambulances billing Medicare are for-profit suppliers.
Under the present regulations, dialysis patients must get treatments three days a week while while waiting for transplants and Medicare will pay for non-emergency ambulances but only for those so ill they can’t get to their medical appointments or treatment any other way. Ambulances are not supposed to be used by people who can walk, sit or ride in a wheelchair. They must find transportation by van or taxi.
Of $5 billion spent on ambulance trips in 2011, $700 million was for rides to dialysis centers. HHS estimates that Medicare would save more than $400 million per year if those states spending the most on ambulance rides per dialysis patient were brought down to the average levels. Those states include Massachusetts, WEst Virginia, South Carolina, New Jersey and Pennsylvania.
Federal authorities have taken action against over a dozen ambulance operators for Medicare fraud in the past year alone. Increased prosecutions are anticipated.
Jeffrey Newman represents whistleblowers