WRAL is reporting today an ambulance service in Roanoke Rapids has agreed to pay the state and federal governments $1.5 million to settle a lawsuit over allegedly fraudulent Medicare and Medicaid claims.
The TV station reported Mark Collier, commander of the Roanoke Valley Rescue Squad, said in a letter to squad members that the settlement is not an admission of wrongdoing. The squad only wanted to avoid the cost of defending the suit, he said.
The U.S. Department of Health and Human Services filed a complaint against the squad last year, alleging that it transported patients for routine medical treatments who didn't meet eligibility requirements for ambulance service.
Collier said in the letter that the squad has tightened its practices by contracting with a new billing company, appointing a compliance officer, conducting more internal and external audits and increasing its review of whether non-emergency dialysis patients have a medical necessity for transportation.
"We want to let everyone know that health care billing today is an extremely complex process, and we have worked with great effort to strengthen and improve not only our billing process but our documentation systems as well," Collier wrote
In December, Jeffery Batts, attorney for the squad, said the government's suit primarily involves a period from 2004 to 2006 and alleged fraudulent activity concerning billing mainly involving the transport of dialysis patients.
Responding to emailed questions from rrspin.com then, Batts said the rescue squad does not anticipate the lawsuit will affect its means or ability to do transports following resolution of the case.
“The government's complaint relates primarily to the period from 2004 to 2006. RVRS denies the government's allegations in the complaint, in particular those alleging any fraudulent activity,” Batts said. “In 2008, out of an abundance of caution, RVRS revised its training program, hired additional review staff and coordinated procedures with referring doctors to ensure no additional issues will arise.”
The complaint, Batts said, related solely to a previous command. “The U.S. Attorney's Office has stated that they have no issues with the procedures utilized by RVRS under its current commander, Mark Collier, who has been in office since 2008. Mark Collier provides his services as commander for RVRS as an unpaid volunteer.”
The attorney said the disagreement concerns documentation related primarily to a portion of the dialysis transports. “RVRS contends that much of that documentation is correct as submitted. RVRS contends that the remaining documentation was submitted in reliance upon information provided by its billing company at the time, which RVRS believed to be in compliance with Medicare regulations.”
Progress has been made to resolve the case, Batts said. “We anticipate the matter can be resolved in the near term.”
The complete list of the original rrspin.com stories on the suit can be viewed by following these links:
