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Posted

Texas seems to be the Mecca of Medicare thieves. No pun intended, but a lot of these thieves tend to be Arabs.

http://www.courthousenews.com:80/2009/06/0...icare_Fraud.htm

Ambulance Firms Accused of Medicare Fraud

By DAVID LEE

Monday, June 08, 2009Last Update: 10:35 AM PT

DALLAS (CN) - The owner and managers of two ambulance companies face a 15-count federal indictment with conspiracy to commit health care fraud, health care fraud and money laundering. They are charged with fraudulently supplying ambulances to dialysis patients who didn't need them: "many of the companies' records revealed that patients rode to their appointments in a captain's chair in the back of the ambulance rather than lying on a stretcher" prosecutors said.

Muhammed Nasiru Usman, of Arlington, Texas; David McNac of Dallas and Shaun Outen of Aubrey are each charged with one count of conspiracy to commit health care fraud and multiple counts of health care fraud. They are accused of falsely billing Medicare, Texas Medicaid, and the Federal Employees Health Benefit Program for non-emergency ambulance transportation of patients to and from dialysis appointments starting in early 2004.

Usman also was charged with one count of money laundering: buying a Lexus with the fraudulently obtained payments from the health-care programs.

Usman, the owner of Royal Ambulance Services, and First Choice EMS, employed McNac as a director of both companies and Outen as a supervisor. Prosecutors say all three were responsible for fraudulent billing exceeding $1.5 million and the payment of more than $550,000 by Medicare, Medicaid, and private insurance.

"The fraudulent claims misrepresented medical conditions of patients in order to qualify for reimbursement from Medicare, Medicaid, and private insurance, and falsely stated that legitimate ambulance services were provided," prosecutors say. "In reality, many of the companies' records revealed that patients rode to their appointments in a captain's chair in the back of the ambulance rather than lying on a stretcher."

The defendants each face up to 5 years in prison and a $250,000 fine if convicted of conspiracy and up to 10 years and a $250,000 fine for each count of health care fraud. Usman also faces up to 10 years, restitution and a $250,000 fine if convicted of money laundering.

The indictment stemmed from "Operation Easy Rider," in which search warrants were executed on ambulance companies across Texas. It was a joint operation between the U.S. Department of Health and Human Services - Office of Inspector General and Texas Attorney General Greg Abbott's Medicaid Fraud Control Unit.

Posted
what a disgrace... deport them

Where does it say they aren't American citizens? I just skimmed it but didn't see that anywhere.

Posted
"The fraudulent claims misrepresented medical conditions of patients in order to qualify for reimbursement from Medicare, Medicaid, and private insurance, and falsely stated that legitimate ambulance services were provided," prosecutors say. "In reality, many of the companies' records revealed that patients rode to their appointments in a captain's chair in the back of the ambulance rather than lying on a stretcher."

Ok, somebody help me out. If you already know you're going to commit Medicare fraud with this transport, why are you DOCUMENTING that fact somewhere other than the paperwork you submit to Medicare? It'd be like murdering somebody, then writing down all the details of the crime and leaving it in your house.

Posted
Where does it say they aren't American citizens? I just skimmed it but didn't see that anywhere.

Pleased someone posted that fact too, just because they have Arab names, doesn't mean they aren't American born and raised even. Don't jump the gun Aaron

Posted

I don't think Aaron jumped the gun, I thought it was funny and took the comment as it was intended...a joke.

It had nothing to do with the names as only one of them was an Arabic sounding name, the other 2 were typical.

Posted
Ok, somebody help me out. If you already know you're going to commit Medicare fraud with this transport, why are you DOCUMENTING that fact somewhere other than the paperwork you submit to Medicare? It'd be like murdering somebody, then writing down all the details of the crime and leaving it in your house.

No... it's worse since PCRs have to be submitted with the bills anyways. It's like committing murder, writing it down in a journal, and then mailing the journal to the police.

Posted

I don't know this for sure, but I am betting that the majority of these cases come up, not because of some really competent government investigator, but because some disgruntled ex-employee ratted them out. And Lord knows there is no shortage of disgruntled ex-employees in the private transfer ambulance business.

Posted
I don't know this for sure, but I am betting that the majority of these cases come up, not because of some really competent government investigator, but because some disgruntled ex-employee ratted them out. And Lord knows there is no shortage of disgruntled ex-employees in the private transfer ambulance business.

nope... none at all

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