$602K SETTLEMENT WITH AMERICAN MEDICAL RESPONSE OF CONNECTICUT REGARDING BILLING PRACTICES
(Hartford, CT) – Attorney General William Tong and U.S. Attorney Leonard C. Boyle today announced a $601,759 civil settlement with American Medical Response of Connecticut resolving allegations that the ambulance service overbilled the Connecticut Medicaid program.
A joint state and federal investigation found that between January 1, 2014 and December 31, 2019 AMR-CT billed the state Medicaid program for “Advanced Life Support” services when they provided only “Basic Life Support” services. The investigation found that even when local fire departments, including West Hartford, Milford, and North Haven had already provided and billed Medicaid for the “Advanced Life Support” services, AMR-CT continued to claim and bill Medicaid for those services they did not provide.
In addition to the $601,759 financial settlement, AMR-CT has entered in a consent agreement with the Department of Public Health to ensure future compliance with primary service area responder laws and billing laws. The DPH consent agreement requires AMR-CT: (1) to cease and desist from providing and billing for advanced life support level of care unless it is the recognized provider of that level of care in that service area or a specific exception applies ( 2) to cease and desist from engaging in false or fraudulent billing; (3) to comply with DPH quarterly reporting and compliance monitoring requirements for one calendar year; and (4) to pay a civil penalty of $25,000 for having engaged in the prohibited conduct in the past.
“AMR-CT billed the state for Advanced Life Support services that local fire departments had already provided. In addition to the significant financial penalty, AMR-CT has entered into a strong consent agreement to ensure this unacceptable overbilling never happens again. Working in coordination with our state and federal partners, our office is prepared to take aggressive action against anyone who abuses our taxpayer-funded healthcare programs,” said Attorney General Tong.
“Connecticut residents should be rest assured that state and federal agencies are always on the watch and ready to collaborate in the investigation and prosecution of organizations whose business practices are not only unethical but illegal as well,” said DPH Commissioner Manisha Juthani, MD. “This settlement should serve as a notice to all that while providing safe and high-quality care is a priority, inaccurate billing processes like this will not be tolerated.”
“This substantial civil penalty and consent agreement reinforce the fact that improper billing to Medicaid triggers investigatory and enforcement action,” said Department of Social Services (DSS) Commissioner Deidre S. Gifford. “I thank Attorney General Tong and U.S. Attorney Boyle and their staffs for their ongoing work with DSS investigators and, in this case, Department of Public Health staff to help safeguard the financial integrity of our public health coverage programs.”
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