United States Attorney's Office for the Southern District of Illinois

11/23/2022 | Press release | Distributed by Public on 11/23/2022 16:06

Ambulance Company Settles Allegations of Billing Medicare for Unnecessary, Non-Emergency Ambulance Transportation

Fairview Heights, Ill. - HealthOne Critical Care Transport Service, Inc. d/b/a MedicOne Medical
Response ("MedicOne") of Marion, Illinois, has agreed to pay $302,124.37 in a civil settlement
agreement resolving allegations the company improperly billed Medicare for scheduled, non-
emergency ambulance transportation.

The government alleges MedicOne's former location in Mount Vernon, Illinois, routinely billed
Medicare for non-emergency ambulance transports to regularly scheduled dialysis treatments when the
services did not meet Medicare requirements. MedicOne typically picked up patients at their
residences or nursing homes and transported the patients to and from dialysis treatment three times
per week, sometimes for years. The government alleges many of MedicOne's non-emergency ambulance
transports did not meet Medicare requirements for coverage because the services were not medically
necessary, particularly when the patients safely rode in other forms of transportation - such as
personal vehicles, medical transport cars, and wheelchair vans - to medical appointments and social
outings.

The Medicare program paid MedicOne hundreds of dollars per round-trip ambulance transport taking
patients to dialysis treatments. To resolve the allegations, MedicOne will pay the United States
$302,124.37 for claims submitted to Medicare between April 2016 and January 2020.

"Billing for unnecessary ambulance transports wastes taxpayer dollars and drains critical funds
from the Medicare program," said U.S. Attorney Rachelle Aud Crowe. "Our office is committed to
protecting the integrity of federal health care programs."

"Health care providers that bill Medicare for medically unnecessary services improperly divert
funds needed to care for beneficiaries while increasing the financial burden on taxpayers," stated
Special Agent in Charge Curt L. Muller of the Department of Health and Human Services Office of
Inspector General (HHS-OIG). "Along with our law enforcement partners, we will continue to
investigate health care schemes to protect the integrity of federal health care programs."

"Public health insurance programs, such as Medicare, can incur significant financial loss when
their programs are exploited. Those losses cost the government and ultimately impact every American
- contributing to the rising cost of health care for everyone," said Federal Bureau of
Investigation (FBI) Springfield Special Agent in Charge David Nanz. "This settlement is a result of
the FBI's commitment to work with our federal and state partners to ensure that federally funded
health care programs are not abused by providers."

This matter was investigated by HHS-OIG, the FBI, and the Illinois tate Police Medicaid Fraud
Control Unit in response to a hotline complaint submitted to HHS-OIG. Assistant U.S. Attorney Laura
Barke prosecuted the case.
Anyone who suspects health care fraud, waste, or abuse is encouraged to report it by calling 1-800-
HHS-TIPS or visiting https://oig.hhs.gov/fraud/report-fraud/.

The claims resolved by the settlement are allegations only, and there has been no determination of
liability.