HOUSTON – Two Houston area men are now in custody on charges of conspiracy to commit health care fraud relating to a pharmacy fraud scheme, announced Acting U.S. Attorney Jennifer Lowery.
Fraud and Compliance Update
U.S. Attorney for the District of Maine Halsey B. Frank announced that Meridian Mobile Health, LLC, doing business as Capital Ambulance, agreed to pay $138,285 to resolve allegation it violated the False Claims Act by billing for medically unnecessary nonemergency ambulance transportation.
According to a press release, the government alleged that from October 2016 through February 2018, Capital improperly billed Medicare for transporting patients discharged from Eastern Maine Medical Center (EMMC) who were not “bed-confined” and did not otherwise medically require ambulance transport.
The government also alleged the medical center provided Capital with certification statements containing incomplete or incorrect information about medical necessity, which the company used to bill Medicare.
Capital identified instances of billing and receiving Medicare payment for medically unnecessary nonemergency ambulance transports originating at EMMC and voluntarily disclosed this information to the government, the release said. The company also cooperated with the government’s investigation and implemented enhanced compliance and remedial measures, the release said.
A settlement is not an admission of liability.