From the U.S. Attorneys Office in Baltimore:
After a multiple-year investigation and the government’s intervention in a whistleblower lawsuit, Hart to Heart Ambulance Services, d/b/a/ Hart to Heart Transportation Services has agreed to pay the United States $1,250,000 to settle allegations under the False Claims Act that it submitted false claims to Medicare for ambulance transport that was not medically necessary.
The settlement agreement was announced today by United States Attorney for the District of Maryland Robert K. Hur and Special Agent in Charge of the Office of Inspector General for the Department of Health and Human Services, Maureen Dixon.
“Companies that submit false bills to the government must be held accountable. The United States Attorney’s Office is committed to taking the steps necessary to protect Medicare and other federal healthcare programs from fraud and abuse and recover taxpayers’ money,” said U.S. Attorney Robert K. Hur.
“When health care providers participate in fraudulent billing schemes in order to increase profits, they steal from the pockets of the taxpayer and jeopardize federal healthcare programs,” said Maureen Dixon, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “We will continue to be relentless in our efforts to hold such providers accountable.”
On November 30, 2018, the United States filed a complaint in U.S. District Court alleging that Hart to Heart, its billing affiliate, EMS Billing Solutions, Inc. (“EMS”), and the owners and operators of those organizations violated the False Claims Act by submitting or causing the submission of false claims to Medicare for ambulance transport that was not medically necessary, and for which the defendants received millions of taxpayer dollars. Medically necessary ambulance transportation requires that a patient’s medical condition is such that other methods of transportation are contraindicated, but Hart to Heart submitted a high rate of ambulance claims for patients who could have been transported by wheelchair van or other means. The complaint cites accounts from numerous former Hart to Heart employees about management’s pressure and directions to falsify documentation to make Medicare reimbursement more likely.
In reaching this settlement, the parties have resolved allegations that, from January 2, 2010 to December 31, 2017, Hart to Heart knowingly submitted fraudulent claims to Medicare for non-emergency Basic Life Support (BLS) ambulance transports hospital discharges that were not medically necessary.
The claims resolved by this settlement are allegations. The settlement is not an admission of liability by Hart to Heart Transportation Services or its affiliates, nor a concession by the United States that its claims are not well founded.
The government’s action in this matter illustrates its commitment to combat health care fraud using the False Claims Act. Tips from all sources about potential fraud, waste, abuse, and mismanagement can be reported to the Department of Health and Human Services, at 800-HHS-TIPS (800-447-8477).
Bryan Arvey, a former Hart to Heart employee, originally filed this lawsuit under the qui tam, or whistleblower, provisions of the False Claims Act, which permits private individuals with knowledge of fraud to sue on behalf of the government for false claims and to share in any recovery. Mr. Arvey will receive approximately $251,000 from the settlement with Hart to Heart. The case is captioned United States, et al. ex rel. Arvey v. Hart to Heart Transportation Services, Inc. et al., Case No. RDB-13-1554.
United States Attorney Robert K. Hur commended the U.S. Department of Health and Human Services – Office of Inspector General for its work in the investigation. Mr. Hur also thanked Assistant United States Attorneys Roann Nichols and Molissa Farber, who handled the case.
Ripping off sick people and taxpayers for personal greed.
So sad.
Your quote sums up the entire medical industry.
Interesting that the govt accepted to settle at 1.25 million, when according to the Baltimore Sun article, they billed/received over 4 million in alleged fraudulent claims! We can all do the math there. I hope they will not be allowed to bill Medicare/Medicaid ever again, but that’s probably not going to happen. I’m sure his father’s business – Hart Heritage – who also uses Hart to Heart was in on this too.
In our case the hospital was the one at fault. I wanted to drive, but they insisted that the patient go by ambulance. When we got the bill I complained to the hospital that it was there fault. They agreed to pay the bill.
I’m glad it worked out for you but you should have drove yourself.
I don’t obviously know the particulars of your incident but I assume you were having a casual conversation over the phone about a non emergency to some employee at a Hospital.
It’s quite easy to say “Nah, I’m driving over there now.”
Hang up the phone.
And then get in your automobile and drive over there.
End of story.
Is this the same company that runs the Alzheimer / old age facilities? If so boy have I heard people who work there tell some stories.
The son/daughter-in-law owns Hart to Heart Ambulance, and the father owns the assisted living. I’ve heard some stories myself about both businesses from employees.
former employee here; I could tell so many stories!
Every time I’ve used Hart to Heart for transport from a hospital to home or to a doctor’s appointment, I had to pay my own way. This includes wheelchair transport.
Sometimes a taxi can be used but not every taxi is equipped to handle a wheelchair. And the back seats of those new taxis are less than generous with the foot/leg space and extremely uncomfortable if you have leg/foot issues (casts, bandages, post surgical wounds, etc.).
If you have wheelchair, there is only one local (Harford Cty.) company that does it (Lion and Lamb transport services) and they are booked weeks in advance. Towson Wheelchair Transport is a good alternative for wheelchair transport anywhere. East Coast Wheelchair Transport no longer services the Fallston area. If you Google local wheelchair transport, Hart to Heart still comes up first.
P.S. Hart to Heart no longer does wheelchair transport….