The most common types of ambulance fraud are upcoming the billing of Medicare or Medicaid at inflated rates, or for rides that are not medically necessary. This was the case in the recent settlement involving Navicent Health Inc., a healthcare facility that operates the second-largest hospital in Georgia, as well as their own line of ambulance services. Exposed by a whistleblower, Navicent paid out $2.5 million for violating the Georgia False Medicaid Claims Act and the federal False Claims Act. Navicent was regularly providing non-emergency transport to patients who were not only ambulant, but did not require medical treatment at the time of transport.
This scheme was particularly difficult to uncover because Navicent owned both the facility and the transportation services. It was common practice for hospital supervisors to encourage paramedics and medical record technicians to falsify documents on both ends in order to bill Medicare and Medicaid for unnecessary rides without drawing much suspicion. These practices resulted in the company pocketing millions of illegally obtained government funds.
Andre Valentine, the whistleblower in this case, was previously employed by Navicent as a paramedic when he noticed something amiss and chose to report his findings to his supervisors. As so often happens to whistleblowers, Valentine was terminated upon his questioning of the fraudulent billing practices. In his whistleblower filing, Valentine alleged that on five separate occasions he was instructed to provide transportation between facilities that was far from “emergent” – but was ordered to alter the service reports to show that he had provided Level 1 Emergency services, fraudulently upcoming those trips. Because ambulance fraud is so frequently covered up, the government relies on whistleblowers such as Valentine in order to root out these fraudulent practices.
Whistleblower Justice Network Can Help You
Whistleblower Justice Network partners with whistleblowers across the nation who seek to expose ambulance fraud schemes that violate the False Claims Act. Though it often seems a frightening choice, we applaud the dedication to moral integrity that it takes to blow the whistle, and are devoted to assisting relators every step of the way.
If you have meaningful information regarding ambulance fraud that you believe is in violation of the False Claims Act, Whistleblower Justice Network can help. Working alongside world-class legal counsel, we will ensure you are protected to the fullest extent of the law and that you receive credit for the information you bring to the U.S. government. Partnering with whistleblowers is all we do. Visit us at www.whistleblowerjustice.net, or call us at 844-WJN-4ALL.
