November 25, 2013 — Our nation’s Medicare program is burdened each year with false claims filed by hospitals, doctors, pharmacies and ambulance companies. To redress the problem, the U.S. Justice Department (DOJ) depends on tips from health care industry insiders. The federal False Claims Act contains qui tam provisions that empower conscientious tipsters to combat fraud themselves by filing a lawsuit on the government’s behalf. To compensate whistleblowers with the courage to step forward, the Act allows informants to share the funds the government recoups.
Los Angeles Ambulance Company Billed Medicare for Unnecessary Ambulance Transportation
Alpha Ambulance Inc. (Alpha) is now defunct and the owners and supervisor of the former California ambulance transportation service have pleaded guilty to conspiracy to commit health care fraud.
Aleksey Muratov, aka Russ Muratov, and Alex Kapri, aka Alexander Kapriyelov or Alex Kapriyelov, owned and operated Alpha, a Los Angeles area ambulance transportation service that specialized in non-emergency ambulance transport for Medicare-eligible, kidney dialysis patients. Danielle Hartsell Medina, an Alpha employee, supervised the training of other company employees.
According to the DOJ, Muratov, Kapri and Medina intentionally provided non-emergency transport services for Medicare beneficiaries with medical conditions that did not require ambulance transport. Muratov and Medina, with Kapri’s approval, directed company personnel to alter the Medicare beneficiaries’ paperwork to hide their medical conditions and justify the unnecessary ambulance transportation. In so doing, the three caused Alpha to make false claims for reimbursement to Medicare.
In the midst of the scam, Medicare notified Alpha that it was to be audited by Medicare. Muratov and Medina then directed Alpha employees — again, with Kapri’s knowledge — to change up patients’ records to reflect phony justifications for the ambulance services.
Between June 2008 and July 2012, Alpha filed over $49 million in Medicare claims for ambulance transportation services. As a result, Alpha received more than $13 million from Medicare in reimbursements, many of which were paid on fraudulent claims.
Tipsters Blow the Whistle on Health Care Fraud
In many cases, health care insiders are on the front lines in the fight against Medicare fraud. The dedicated workers are entitled to an explanation of their interests under the False Claims Act prior to filing suit. With experienced whistleblower lawyers in offices from coast to coast, Waters & Kraus is available to protect you. When you’re ready to collaborate with the government to tackle Medicare fraud, contact us by email or phone our False Claims Act lawyers at 855.784.0268 to learn more about our nationwide qui tam practice and how we can assist you.