Hart to Heart, an ambulance service provider operating in Salisbury, has agreed to pay $1.25 million to resolve allegations for submitting false claims for payment to Medicare between 2010 and 2017.
In 2015, a whistleblower filed a False Claims Act lawsuit alleging that Hart to Heart was billing Medicare for ambulance transports that were medically unnecessary. Though it agreed to a sizable settlement, the Maryland-headquartered company has made no admission of guilt.
"Hart to Heart denies all allegations that were made against the Company. Although Hart to Heart believed it would be completely vindicated if the case went to trial, the Company decided it was in its best interest to accept a settlement," a spokesperson for the company said in a statement.
The whistleblower who exposed the alleged fraud is Bryan Arvey, a Salisbury resident who was employed by the company as an ambulance driver. According to his complaint, Hart to Heart falsified claims to bill Medicare for transporting recently discharged patients at Peninsula Regional Medical Center.
Arvey’s lawsuit explained the alleged fraud’s methodology in detail. He claimed that paramedics deliberately asked hospital staff to have patients who could walk lie down in bed, in order to justify the need for an ambulance to take them home after discharge, and the subsequent, lucrative Medicare billing.
In 2018, the government decided to join the whistleblower’s lawsuit, alleging that the fraud had cost Medicare millions of dollars, which could have been spent in providing much-needed care to beneficiaries of the program. The complaint also states that Hart to Heart pressured staff to falsify records to boost Medicare reimbursements.
The U.S. Attorney for the District of Maryland said in a statement that the Department of Justice is “committed to taking the steps necessary to protect Medicare and other federal healthcare programs from fraud and abuse and recover taxpayers’ money."
While the original whistleblower suit also cited Peninsula Regional Medical Center (PRMC) as an active participant in the fraud, prosecutors decided to drop the charges against the facility and its operators. PMRC said in a statement that it was in no way involved in the misconduct and that it had cooperated with the DOJ’s probe “every step of the way.”
Whistleblower Bryan Arvey will receive a $251,000 award for his assistance in the recovery of taxpayer funds. "He saw something he did not think was proper. He raised the alarm about it," a spokesperson for the tipster commented. "He is very gratified the system worked. . .”
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