Tuesday, March 15, 2016

Philadelphia Ambulance Company Employee Sentenced To 37 Months In Prison For Medicare Fraud in Transporting Patients Who Were Ambulatory and Fabricating Documentation

Non-emergency ambulance companies who bill Medicare have been a significant target for the Office of Inspector General across the United States. In these cases, physicians ordered transportation but the government has shown that the ambulance cases knew that the patients were ambulatory. A defendant in a Philadelphia case was sentenced last week.

On March 9, 2016, Fritzroy Brown of Philadelphia was sentenced to 37 months in prison for a healthcare fraud case centering on Brotherly Love Ambulance, Inc.  In addition to the prison term, U.S. District Court Judge Gerald J. Pappert ordered three years of supervised release, restitution in the amount of $2,015,712.52 to Medicare, restitution of $14,150 to the Commonwealth of Pennsylvania, and a $300 special assessment. This sentence was after a guilty plea without a trial.

Mr. Brown was a certified Emergency Medical Technician (EMT) with Brotherly Love.  While employed by Brotherly Love, Mr. Brown allegedly transported patients who were able to walk and could travel safely by means other than ambulance and who, therefore, were not eligible for ambulance transportation under Medicare requirements.  

This case was unusual since the government also charged Medicare beneficiaries with taking payments for riding with the ambulance company and for making false statements to government investigators.

The government alleged that Mr. Brown and other conspirators falsified reports to make it appear that the patients needed to be transported by ambulance when he knew that the patients could be safely transported by other means and, in fact, many of them could walk.  In addition, the government further alleged that Mr. Brown and other conspirators paid kickbacks to patients to ensure that they would use Brotherly Love Ambulance for services which were not medically necessary.  

The company also allegedly transmitted bills for ambulance services for patients who were not transported by ambulance, but whom Mr. Brown and others drove in personal vehicles.  The government further claimed that Mr. Brown and others completed documentation of these transports that made it appear that the individuals had been transported in an ambulance when they had not, and that misrepresented the medical care provided to and safety precautions taken for these patients. 


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