Air Methods Corporation, a national provider of air medical transport services, agreed to pay the federal government $1,050,873, to resolve civil allegations that it had failed to return known overpayments received from Medicare, Kentucky Medicaid, Tricare, and the Department of Veterans Affairs. The United States alleged that Air Methods violated the False Claims Act, by improperly retaining overpayments for more than 100 flights that it knew to be medically unnecessary and, therefore, ineligible for reimbursement by federal healthcare programs. Federal healthcare programs, including Medicare and Kentucky Medicaid, only provide reimbursement for air ambulance transportation if the beneficiary’s medical condition requires air transport, and transport by ground ambulance is not appropriate.
The United States alleged that Air Methods’ internal review process identified flights that did not meet these coverage requirements, including instances where patients were flown despite not meeting trauma criteria. The False Claims Act, a federal law that prohibits causing the submission of false or fraudulent claims to the federal government, also forbids knowingly concealing, avoiding, or decreasing an obligation to pay the government. As such, healthcare providers also face False Claims Act liability when they fail to return known overpayments to federal healthcare programs.
