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Tennessee False Claims Act Yields $500,000 Settlement by Ambulance Company
As a Tennessee False Claims Act attorney, I am pleased to report that First Call Ambulance Services paid $500,000 in May 2014 to settle a Tennessee False Claims Act lawsuit, alleging improper billing by the medical transport company. The undisclosed whistleblower is allowed to receive up to 30 percent of the amount in recognition of his initiative that led to a fraud investigation by federal and state authorities and recovery of Medicaid funds. The qui tam lawsuit is the latest in a series of hundreds of such whistleblower actions encouraged and protected under the Tennessee Medicaid False Claims Act, leading to reclaiming of embezzled taxpayers’ money running into millions of dollars.
The Ambulance False Claims Act Lawsuit
A Tennessee whistleblower approached the court accusing First Call Ambulance Services of upcoding and submitting false bills to claim money from state and federal Medicaid fund. According to the qui tam lawsuit filed as per the Tennessee Medicaid False Claims Act, First Call made fake claims claimed to have provided advanced life support to patients during medical transport to claim higher amounts while patients were provided much cheaper basic life support while on the ambulance. Our firm has successfully handled upcoding cases involving the Tennessee False Claims Act.
A probe by the U.S. Attorney’s Office for the Middle District of Tennessee and the Tennessee Bureau of Investigation following the whistleblower false claim lawsuit found First Call guilty of submitting up-coded bills. The TN false claim act lawyer representing the submitted evidence to highlight that First Call billed many patients “who plainly did not need to be transported by ambulance or were able to walk to the vehicle and enter unassisted” for advanced life supports.
While advanced life support was not offered in most cases as claimed and only basic life support was administered. There are many instances where extensive resuscitation efforts was claimed to be provided to patients, who did not have any kind of require life support on their way to hospital. Advanced life support involves extensive medical care and resuscitation efforts and hence is more expensive than basic life support services.
Tennessee False Claims Act: What is Upcoding
Upcoding refers to making a misleading claim for reimbursement for medical services more expensive than those performed. Each medical procedure has been assigned current procedural terminology or a code, which was quoted in the bill by healthcare provider and professionals when submitted for Medicaid or insurance reimbursement. When bills are submitted, higher or lower amount of payment is done based on these codes.
Many seeking reimbursements make fraudulent claims by mentioning codes of higher-paying care than those actually rendered. There may be a bill mentioning code for ultrasound or MRI, the actual service was just a quick check up.
A Tennessee False Claim Act Lawsuit
Tennessee Medicaid False Claims Act recognizes upcoding as one of the fraudulent practices punishable with monetary penalty. Anyone found involved in submitting up coded bills is likely to be fined three times of the money embezzled along with $25,000 in penalty. The Medicaid False Claims Act rewards whistleblowers filing qui tam lawsuits with up to 30 percent of the total money recovered from the accused.
Healthcare false billing and upcoding are common occurrences addressed by the Tennessee False Claims Act. If you have any evidence to expose any such fraud, contact an expert False Claims Act attorney to discuss your options whistleblower or qui tam actions.
To Contact a Tennessee False Claims Act Today
We help whistleblowers on a contingency basis, meaning there is no fee charged for our work unless there is a recovery. We also front any and all expenses. No matter where you are located — we will represent you. We will come to you, you will not have to come to us. Attorneys in our firm and attorneys that we work with on Whistleblower, Qui Tam, False Claims Act cases have represented a host of persons making claims, for violations of federal tax law, Medicare law and more. For more information, please contact our team of whitsleblower and qui tam attorneys today.
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Our offices will review potential false claims act cases in all fifty states, including Tennessee, Arkansas, Mississippi, Kentucky and Alabama.