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EMS Live in Wisconsin: Medicare fraud, whistleblower protection and reducing False Claims Act risks

EMS Live in Wisconsin
May 09, 2017

This podcast episode was recorded on May 9 and was dedicated to discussing Medicare fraud, whistleblower protection and steps to reduce your False Claims Act risk. 

Wendy Arends authored an article involving a $12.7 million settlement in a whistleblower Medicare fraud case against MedStar Ambulance in Massachusetts. The former billing manager was the whistleblower in this case and reported the wrongdoing. MedStar Ambulance is alleged to have: (1) billed for transports that were not medically reasonable and necessary; (2) billed for higher levels of services than patients’ conditions necessitated; and (3) billed for higher levels of services than were actually provided.

Besides the MedStar case, we also discussed how to reduce an ambulance service's Fraudulent Claims Act risk with internal policy and procedures. Even if your ambulance service uses a third-party billing company to process runs, code them and bill Medicare, it doesn't release you as the ambulance company from liability, compliance, completing audits and any unintended consequences that may arise.

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