Ambulance company to pay $948,000 to settle Medicare Fraud suit

Lafferty Enterprises doing business as Trans-Star Ambulance Services will pay $948,000 to resolve allegations  ambulance s that it filed fraudulent claims with the federal Medicare program. Medicare will only pay for an ambulance to take patients to and from dialysis if other forms of transportation pose a medical risk, and that was not the case in this instance, the government argued. This settlement is just one of scores of similar cases and recent Government allegations that ambulance companies are engaged in massive fraud by over-billing Medicare and Medicaid and also charging for services that are not allowed. In many instances, for example, the ambulance companies are billing for advanced care life support when the ambulance run does not provide advanced services.

As part of the settlement, Trans-Star will also have to undertake “substantial internal compliance reforms” and its claims will be reviewed by a third party for the next three years.

“It is vitally important that the resources available to federally funded healthcare programs be used only to pay for medically necessary services,” Kerry B. Harvey, U.S. Attorney for the Eastern District of Kentucky, said in a news release. “Our office and our agency partners are committed to protecting the integrity of these important programs on which so many of our citizens depend.”

Jeffrey Newman represents whistleblowers