United States Attorney Halsey B. Frank said today, Feb. 23, that North East Mobile Health Services, based in Scarborough and with a station in Rockport, has entered into a civil settlement agreement with the U.S. in which it will pay $825,000 to resolve allegations that it violated the federal False Claims Act by providing medically unnecessary ambulance transportation. Maine Medical Center, of Portland, also agreed to pay $600,000 pursuant to a separate civil settlement.
North East's settlement resolves allegations that it improperly billed Medicare for non-emergency ambulance transportation of patients discharged from MMC from 2007 onward, according to a news release from U.S. Attorney’s Office, District of Maine, in Portland.
The release said:
The government alleged that North East improperly billed Medicare for ambulance transports of patients it falsely claimed were either "bed-confined" or for whom such transport was otherwise medically necessary. The settlement also resolves allegations that North East knowingly retained Medicare overpayments.
MMC's settlement resolves allegations that MMC personnel provided North East with statements containing incomplete or inaccurate information about the medical necessity of transporting patients by ambulance, which North East thereafter used to bill Medicare.
Both North East and MMC cooperated with the investigation. Federal authorities encourage health care providers to cooperate with investigations involving the possible submission of false claims to federal programs.
The case was investigated by the Office of Inspector General for the U.S. Department of Health and Human Services. The civil action is docketed United States v. North East Mobile Health Services, 2:18-cv-00081-NT (D. Me.).