American Medical Response of Connecticut, Inc. (“AMR”), has entered into a civil settlement agreement with the federal and state governments and has paid $601,759 to resolve allegations it submitted improper claims to Medicare and Medicaid for ambulance services. AMR is an ambulance company operating in Connecticut. The federal and state governments allege that AMR would often bill Medicare and Medicaid for ALS (paramedic) services when it was only providing the BLS (ambulance transport) services. For claims submitted to Medicare, billing for ALS services in “joint response” situations would have been proper if AMR had a written billing agreement in place with the local fire departments, which it did not during relevant time period. For claims submitted to Connecticut Medicaid, in many cases, both AMR and the local fire departments billed Medicaid for ALS/paramedic services. As a result, Medicaid actually paid twice for the paramedic services, once to the local fire departments and a second time to AMR. To resolve the governments’ allegations, AMR paid $601,759, which covers claims submitted to the Medicare and Medicaid from January 2014 through December 2019. AMR also entered into a consent agreement the with the Connecticut Department of Public Health in which they agreed to cease and desist the prohibited conduct and to pay a $25,000 civil penalty to the State of Connecticut.
