Sturbridge whistleblower gets $3.56M in ambulance settlement
A Sturbridge woman will receive $3.56 million of a
$12.7 million settlement for her role as the whistleblower who alleged
that an ambulance company fraudulently billed Medicare for unqualified
services.
Dale Meehan, a former billing
manager for Leominster-headquartered MedStar Ambulance Inc., alleged
that MedStar and its four related companies - Pioneer Valley EMS Inc.,
MedStar EMS Inc., Metrowest Emergency Services Inc., and Fitchburg
Emergency Medical Services Inc., - fraudulently billed
Medicare between 2005 and 2013 for ambulance services, according to a
2013 civil complaint filed in U.S. District Court. All the companies are
run by brothers Gregory and Nicholas Melehov, according to the
complaint.
The alleged fraud included billing for ambulance trips that were not medically necessary and "up-coding" runs - or making them seem more serious than they actually were - to get higher payments from the government, according to the complaint.
Ms.
Meehan also alleged she was fired for her continued questions and her
attempts to correct the fraudulent billing, according to the complaint.
MedStar
Ambulance Inc., and its related companies have agreed to pay $12.7
million to settle the False Claims Act lawsuit, according to a press
release Friday from the office of Ms. Meehan's lawyer, Jeffrey A.
Newman. Ms. Meehan will receive $3.56 million of the settlement under
the federal False Claims Act, which allows whistleblowers to sue
companies that are defrauding the government and receive a reward if the
government recovers any funds as a result.
"Dale
Meehan courageously came forward and told the truth about this
multimillion dollar fraud scheme to make more profits," Mr. Newman said
in the press release. "The Medicare system is already severely
over-taxed at a time when every penny should be used for those who need
it."
As part of the settlement, MedStar
must also enter into a Corporate Integrity Agreement with the Office of
the Investigator General.
There are no criminal charges involved, according to lawyers.
"MedStar
was pleased to work with the Department of Justice to resolve the
overpayment issues," said lawyer Kenneth C. Pickering. "There was
absolutely no intent by MedStar to overbill, and the company is glad to
turn its attention back to providing unparallelled ambulance service in
the region."
He said the case also involves a claim
against MedStar for retaliation which remains in litigation, which the
company "vehemently denies."
There is a lot more to this story than what is been printed . i wish med star would of fought this. but i guess a long court battle cost money also ! big part of this was considered unbillable claims ! couldn't read signatures in complete run reports . and who was in charge of billing at the time hummm the one that received all the money !!
ReplyDeleteMore to It, ??? The fact is its about time someone got caught ripping off people when they need help the most, Sending 2 ambulances on every call is nothing more than ROBBERY when the victim has no say in it, Its about time the insurance companies get a break.
ReplyDeleteReminds me of when a child of mine needed transport from Gardner to Worcester, Woods had everything "in control". got as far as 190 and they realized THEY left the child's charts in Gardner. Guess who paid for the multiple trips to and from Worcester to retrieve what they were supposed to be in control of. Naturally they just passed the exhorborint charges on to the insurance company, BUT we did not have insurance and they did not give us a break at all. I for one was glad when they lost the contract in Gardner