AmeriCare Ambulance Service to Pay $5.5 Million to Settle False Claims Act Lawsuit Initiated by Healthcare Whistleblower
On Tuesday, January 30, 2018, United States Attorney for the Middle District of Florida Maria Chapa Lopez announced the settlement of a false claims act case against AmeriCare Ambulance Service, Inc. and its sister company, AmeriCare ALS, Inc. (collectively, AmeriCare). AmeriCare, the largest ambulance service provider in Tampa, Florida., will pay $5.5 million and enter into an integrity agreement with the Inspector General of the U.S. Department of Health and Human Services as part of an agreement to resolve the lawsuit filed by whistleblower Ernest Sharpe, a former paramedic represented by several qui tam law firms.
The complaints filed by Mr. Sharpe and, later, the U.S. Government allege that AmeriCare defrauded Medicare over a period of at least seven years. Medicare only reimburses ambulance service providers for non-emergency ambulance transportation when no other mode of transportation can be used without endangering the patient’s health. AmeriCare allegedly provided unnecessary ambulance services to Medicare patients and sought reimbursement in violation of this rule.
According to Mr. Sharpe, whose allegations are echoed by numerous other former AmeriCare employees, AmeriCare’s improper claims for reimbursement were not the result of negligence or oversight. Instead, the company had a policy of shading and outright misrepresenting patients’ conditions at the time of their ambulance ride in order to ensure that claims for reimbursement were approved by Medicare. During his training and employment as an AmeriCare paramedic, Mr. Sharpe was allegedly pressured repeatedly to lie in reports submitted to Medicare. His complaint contains examples of his supervisors trying to coach and persuade him to submit shoddy and incorrect descriptions of patient pick-ups in order to ensure that AmeriCare would get reimbursement. Mr. Sharpe resisted this pressure, continuing to write what he believed were accurate reports and eventually filing a complaint with a state regulator. He alleges that he was fired for his honesty after barely five months on the job.
Unscrupulous healthcare providers have found many different ways to take advantage of vital government programs like Medicare. This illegal and unethical behavior constitutes “an assault on federal health care programs and the American taxpayer,” according to a federal agent investigating the AmeriCare case. The False Claims Act has been an important tool in the fight against government programs fraud since it was first enacted to combat war profiteering during the Civil War. But the system depends on healthcare whistleblowers like Ernest Sharpe telling their story with the help of an experienced False Claims Act attorney.