December 5, 2013 — Our nation’s Medicare program is inundated each year with fraudulent claims filed by physicians, hospitals, pharmacies and even ambulance service providers. To confront the problem, the U.S. Department of Justice relies on tips from health care workers themselves. The federal False Claims Act includes qui tam provisions that allow conscientious tipsters to tackle the issue head-on by filing a lawsuit for the government. To compensate whistleblowers brave enough to step forward, the Act permits informants to retain a share of the funds the government recoups.
Houston Ambulance Transportation Company Billed Medicare for Services Not Provided
The former owner of a Houston ambulance services company has been convicted of health care fraud. Gwendolyn Climmons-Johnson, who ran Urgent Response EMS (Urgent Response), was convicted after a three day jury trial for health care fraud and submitting false claims to Medicare. Urgent Response purportedly offered non-emergency ambulance rides to Medicare beneficiaries residing in the Houston, Texas area.
According to the Justice Department, between January 2010 and December 2011, Climmons-Johnson conspired with others to submit false claims for reimbursement to Medicare for ambulance services to Medicare beneficiaries that were either medically unnecessary or not provided at all. As the manager of the daily operations at Urgent Response, Climmons-Johnson either filed herself, or caused to be filed, around $2.4 million in fraudulent claims to Medicare for ambulance services. To cover up the fraudulent nature of the Medicare claims, Urgent Response falsified the patient records of the Medicare beneficiaries involved.
At sentencing in February, 2014, Climmons-Johnson could receive as much as ten years in prison for each of the counts on which she was convicted.
Informants Blow the Whistle on Health Care Fraudsters
Many times, health care workers find themselves on the front lines in the battle against Medicare fraud. These dedicated employees deserve an explanation of their interests as provided in the False Claims Act before they bring suit. With knowledgeable whistleblower attorneys in offices from coast to coast, Waters & Kraus has the resources to protect you. When it’s time to collaborate with the government on False Claims Act violations, contact us by email or call our qui tam lawyers at 855.784.0268 to find out more about our Medicare/Medicaid fraud practice and how we can help you.