Government Intervenes in Ambulance Service Medicare Fraud Lawsuit Filed by Berger Montague and Wenzel Fenton Cabassa
August 7, 2017. PHILADELPHIA–Berger Montague and Wenzel Fenton Cabassa, P.A. of Tampa are pleased to announce that the government has intervened in a False Claims Act lawsuit filed by both firms on behalf of their client against AmeriCare Ambulance Service. The lawsuit alleges that AmeriCare defrauded the government by billing Medicare for thousands of medically unnecessary services.
AmeriCare, a company based near Tampa, Fla., provides ambulance transportation services and often provides these services to Medicare beneficiaries. Medicare only covers ambulance transportation services when other methods of transportation (such as a non-ambulance stretcher van or a car) would endanger a patient’s health. The firms’ client worked as a paramedic at AmeriCare, and during his employment, became aware that AmeriCare was providing medically unnecessary ambulance transportation services to Medicare beneficiaries.
The client alleges that AmeriCare routinely asked him to falsify records to misrepresent the medical condition of patients to create the false impression that the services were medically necessary. When he expressed concerns about this to AmeriCare management, he was fired. The client then filed claims under the False Claims Act.
In July 2017, the government announced that it was intervening in the case against AmeriCare and recently filed a complaint which provided extensive details of AmeriCare’s misconduct. The government alleges that AmeriCare submitted thousands of claims to Medicare for medically unnecessary ambulance transportation services and thus received government funding for services not covered by Medicare. During its investigation, the Government was able to speak with various administrators and other employees at AmeriCare, who confirmed that AmeriCare had implemented this scheme.
The firms’ client is also pursuing a separate claim based on AmeriCare’s decision to terminate him when he expressed concerns about this scheme. The False Claims Act specifically forbids employers from retaliating against employees for attempting to investigate or stop violations of the False Claims Act.
Shauna Itri, counsel for the whistleblower stated: “We are extremely proud to be representing Ernest Sharp in this case.” Itri further stated, “The government has been impressive in the way it diligently investigated this ambulance transport case.” Wenzel added, “The United States faces a crisis because of the rising cost of healthcare. Fraud must stop — it hurts patients who won’t be able to get care. All healthcare workers should be vigilant about their employer’s misdeeds and call us so we can help stop fraud and protect their job rights.”
The case is United States ex rel. Sharpe v. AmeriCare Ambulance Service, No. 8:13-cv-01171 (M.D. Fla. 2013).
For more than a decade, the Berger Montague, Whistleblowers, Qui Tam & False Claims Act Practice Group has represented whistleblowers in matters involving healthcare fraud, defense contracting fraud, IRS fraud, securities fraud, and commodities fraud, helping to return more than $3 billion to federal and state governments. In return, whistleblower clients retaining Berger Montague to represent them in state and federal courts have received more than $500 million in rewards.
Wenzel Fenton Cabassa, P.A. is a full-service employee rights law firm and represents employees in a variety of cases, including whistleblowing, retaliation, harassment, discrimination, sexual harassment, unpaid wages and overtime, contract negotiations, claims under the Family and Medical Leave Act, and claims under the Fair Credit Reporting Act.