BALTIMORE, Md. – A $1.25 Million settlement has been reached between private ambulance company Hart to Heart Transportation Inc. and the United States Department of Justice after a lawsuit was filed claiming the ambulance company fraudulently received tens-of-millions on dollars in Medicare reimbursements.
Medicare reimburses ambulance providers based on the type of service provided, the level of services rendered, and the mileage. But it only reimburses companies for ambulance transportation that is “medically necessary”.
In February, 2018, WBOC learned of the lawsuit in which the plaintiffs, The United States and Brian Avery, a former Hart to Heart worker, claimed the company required it’s drivers and EMT’s to falsify reports and use inaccurate billing codes to reflect that ambulance services were “medically necessary” even when they were not.
In a letter from the Department of Justice dated June 17th, 2019, United States Attorney Robert K. Hur notified the presiding judge that the $1.25 million settlement had been reached.
According to the settlement, the agreement is neither an admission of liability on the ambulance company’s part nor a concession by the United States that its claims are not well-founded.
The DOJ says the settlement, which will be paid over five years, does not reimburse the Medicare program fully for the claims paid to Hart to Heat.
The initial legal filing by the DOJ listed Peninsula Regional Medical Center as a defendant. However, PRMC is not listed as a defendant in the final settlement. Hart to Heart says it no longer is contracted with PRMC. It does continue to provide services for Beebe Healthcare and Bayhealth in Kent County and Sussex County, Del.