Ambulance services contribute to as much as $350 million in fraudulent Medicare billing every year, often transporting healthy patients or double billing for two patients at one time, according to ABC News.
Assistant special agent for the Office of Inspector General (OIG), Ron Kerr, told the news organization that businesses treat ambulances like a "glorified taxi service," often transporting patients who are healthy enough to drive themselves and then billing Medicare for as much as $400, round trip. Ambulance companies target dialysis patients who require transportation multiple times each week--a scam that ultimately costs Medicare more than $60,000 per patient.
Kerr added that drivers often search for patients in lobbies or waiting rooms, and then pay them with gifts or cash to ride in the ambulance, allowing the company to bill Medicare for the service. Recruiting just 20 patients who use the service multiple times each week accumulates more than $1 million in annual revenue.
"Some of the fraudsters that enter into the ambulance fraud may have been drug dealers at one point but it is just more lucrative to get involved in healthcare fraud," Kerr told ABC News, adding that Medicare is a $600 billion program. "It is where the money is."
ABC News accompanied federal agents in Huntington Valley, outside of Philadelphia, an area where ambulance companies outnumber taxi companies. Undercover video shows patients riding in the front seat or two patients riding in an ambulance at once, a practice that constitutes double billing. In November, charges were brought against four Philadelphia Medicare beneficiaries accused of accepting kickbacks and taking unnecessary ambulance trips, FierceHealthPayer: AntiFraud previously reported.
The Centers for Medicare & Medicaid Services (CMS) Deputy Administrator Shantanu Agrawal told ABC News that the agency is aware of the fraudulent billing that is pervasive among ambulance companies and is working to get bad actors out of the system. In December, CMS imposed preauthorization requirements on non-emergency ambulance trips in New Jersey, Pennsylvania and South Carolina, three hot spots for ambulance fraud.
- read the ABC News article