Healthcare Fraud: Nicholas and Gregory Melehov Have Agreed To Pay to Resolve Allegations Concerning Inflated Medicare Claims for Ambulance Transports

<h2>Family-Owned Ambulance Company to Pay &dollar;12&period;7 Million to Resolve False Claims Allegations<&sol;h2>&NewLine;<p>BOSTON – The U&period;S&period; Attorney’s Office announced that Medstar Ambulance&comma; Inc&period;&comma; four of its subsidiaries&comma; and its two owners&comma; Nicholas and Gregory Melehov&comma; have agreed to pay &dollar;12&period;7 million to resolve allegations concerning inflated Medicare claims for ambulance transports&period;<&sol;p>&NewLine;<div class&equals;"mh-content-ad"><script async src&equals;"https&colon;&sol;&sol;pagead2&period;googlesyndication&period;com&sol;pagead&sol;js&sol;adsbygoogle&period;js&quest;client&equals;ca-pub-9162800720558968"&NewLine; crossorigin&equals;"anonymous"><&sol;script>&NewLine;<ins class&equals;"adsbygoogle"&NewLine; style&equals;"display&colon;block&semi; text-align&colon;center&semi;"&NewLine; data-ad-layout&equals;"in-article"&NewLine; data-ad-format&equals;"fluid"&NewLine; data-ad-client&equals;"ca-pub-9162800720558968"&NewLine; data-ad-slot&equals;"1081854981"><&sol;ins>&NewLine;<script>&NewLine; &lpar;adsbygoogle &equals; window&period;adsbygoogle &vert;&vert; &lbrack;&rsqb;&rpar;&period;push&lpar;&lbrace;&rcub;&rpar;&semi;&NewLine;<&sol;script><&sol;div>&NewLine;<p>&OpenCurlyDoubleQuote;Our office is committed to finding and eradicating Medicare fraud wherever it occurs&comma;” said United States Attorney Carmen Ortiz&period; &OpenCurlyDoubleQuote;While we recognize that Medicare does and should pay for medically necessary ambulance services&comma; it is our job to ensure that ambulance providers do not take advantage of the system or the patients&period; This settlement is part of the office’s ongoing effort to stamp out health care fraud and return money to taxpayers&period;”<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;We expect those who participate in the Medicare program to provide services&comma; including ambulance services&comma; based on the medical needs of patients rather than their desire to maximize profits&comma;” said Principal Deputy Assistant Attorney General Benjamin C&period; Mizer&comma; head of the Justice Department’s Civil Division&period; &OpenCurlyDoubleQuote;The Department of Justice is committed to ensuring that those who abuse the Medicare program will be held accountable for their actions&period;”<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;Improperly billing the government for services affects every American taxpayer&comma;” said Harold H&period; Shaw&comma; Special Agent in Charge of the Federal Bureau of Investigation&comma; Boston Field Division&period; &OpenCurlyDoubleQuote;The settlement with MedStar Ambulance&comma; Inc&period; is a result of the FBI’s continued effort to combat inappropriate and questionable billing practices in the area of ambulance transport fraud&period;”<&sol;p>&NewLine;<p>&OpenCurlyDoubleQuote;Ambulance service companies should be focused on the needs of the patients&comma;” said Department of Health and Human Services&comma; Office of Inspector General Special Agent in Charge Phillip Coyne&period; &OpenCurlyDoubleQuote;Billing Medicare for ambulance rides that were unnecessary or at a higher rate than could be medically justified is unacceptable&period; Together with our law enforcement partners we will seek out and stop this fraudulent behavior&period;”<&sol;p>&NewLine;<p>The agreement resolves allegations that Medstar wrongfully billed Medicare for ambulance services that were not medically necessary or for higher levels of ambulance services than were required or provided&period; Medstar and its subsidiaries – Medstar EMS&comma; Inc&period;&comma; MetroWest Emergency Medical Services&comma; Inc&period;&comma; Fitchburg Emergency Medical and Pioneer Valley EMS&comma; Inc&period; – provide ambulance services to municipalities&comma; hospitals and skilled nursing facilities in central and western Massachusetts&period; The allegations came to the government’s attention when Dale Meehan&comma; a former employee in Medstar’s billing office&comma; filed a complaint in federal court &lbrack;captioned below&rsqb; alleging wrongful billing by Medstar&period; The government contends that after Medstar took its ambulance billing services in house around 2011&comma; it engaged in a pattern and practice of submitting false claims to Medicare for ambulance transport services in which &lpar;1&rpar; the services did not qualify for reimbursement because the transports were not medically reasonable and necessary&comma; and &lpar;2&rpar; Medstar billed for higher levels of ambulance transport services than were required by patients’ conditions or billed for higher levels of ambulance transport services than were actually provided&period;<&sol;p>&NewLine;<p>Once Medstar became aware of the investigation in late 2014&comma; it quickly endeavored to put in place meaningful change&comma; including revamping its ambulance billing software and training its billing employees&period; Medstar has worked cooperatively with the government throughout its investigation&comma; and has taken swift action to address past misconduct&period; In addition&comma; Medstar has agreed to a corporate integrity agreement with the U&period;S&period; Department of Health and Human Services&period;<&sol;p>&NewLine;<p>U&period;S&period; Attorney Ortiz&semi; Principal Deputy AAG Mizer&semi; FBI SAC Shaw&semi; and HHS SAC Coyne&comma; made the announcement&period; The case was handled by Assistant U&period;S&period; Attorneys Jessica Driscoll and Lisa Asiaf-Schlatz of Ortiz’s Office&comma; and Trial Attorney Kelley Hauser of the Department of Justice’s Civil Division&period;<&sol;p>&NewLine;<p><u>HHS Hotline<&sol;u>&colon; The government encourages anyone with information about the practices described above&comma; or similar practices involving ambulance billing&comma; to contact the Department of Health and Human Services Office of Inspector General Hotline via telephone&comma; 1-800-HHS-TIPS &lpar;1-800-447-8477&rpar;&comma; or in writing via <a href&equals;"https&colon;&sol;&sol;forms&period;oig&period;hhs&period;gov&sol;hotlineoperations&sol;"><u>https&colon;&sol;&sol;forms&period;oig&period;hhs&period;gov&sol;hotlineoperations&sol;&period;<&sol;u><&sol;a><&sol;p>&NewLine;<p><u>United States ex rel&period; Meehan v&period; Medstar Ambulance&period; Inc&period;&comma; et al&period;<&sol;u>&comma; No&period; 13-CV-12495-IT &lpar;D&period; Mass&rpar;<&sol;p>&NewLine;<p><a href&equals;"https&colon;&sol;&sol;www&period;justice&period;gov&sol;usao-ma&sol;pr&sol;family-owned-ambulance-company-pay-127-million-resolve-false-claims-allegations">Original PressReleases&&num;8230&semi;<&sol;a><&sol;p>&NewLine;

Health Care Fraud