Medicare Audits Biting Houston Area Ambulance Companies Where It Hurts – In the Bottom Line

I have previously posted about the travails of one Houston ambulance service owner who had taken his complaints about the treatment of dialysis patients to the media.  Apparently, the initial reports were only the beginning – I don’t watch the local Fox station, so I missed the follow up of the initial report.  After the jump is the written article and my comments:

My take on this is that this is not retaliation – it is a natural outgrowth of the get tough on fraud and abuse campaign that has been going on with regards to Medicare and Medicaid since at least 2003 and probably much earlier than that.  It is going to get much worse before it gets better and unless you understand as an ambulance service owner that the dialysis patients are fraught with a huge amount of downside risk at the moment, I predict you will go out of business because of a Medicare audit.

And $360,000 is nowhere near the most I have heard about with regards to a recoupment from an ambulance company.  Not by half.

Full disclosure – I have spoken with Mr. Strickland in the past, roughly around the time of the original report.  But my phone hasn’t rung since then.

Ambulance Company Owner Accuses Medicare Of Retaliation

Medicare: Dialysis patient doesn’t need ambulance

Investigative Reporter

HOUSTON – No one would argue Houston became a hot bed for Medicare fraud involving private ambulance companies and dialysis patients.

Unscrupulous ambulance companies were billing millions to Medicare to transport patients who could easily make the trip in a car.

== Fraudsters Hurting Legitimate Businesses ==

“My liver is damaged,” Chris Mozingo said.

You can see for yourself: The only way Mozingo can get to dialysis treatment is in the back of an ambulance.

“I know there’s people that would literally die without this service,” Mozingo said.

Arrington Strickland, owner of United EMS, contacted FOX 26 Investigates in the fall of 2010.

He wanted the public to know how Medicare’s crackdown on fraud was causing lengthy payment delays for him and other legitimate ambulance companies.

“They’re looking at ways not to pay and that’s the consistent issue with Medicare,” Strickland said.

== Medicare Orders Owner to Pay Up ==

Our original investigation aired Nov. 15. Strickland got a letter from Trailblazer Health Enterprises, a company contracted by Medicare, the following day.

“It seems a little retaliatory that they would turn around the day after it aired to request an audit on payments received when the issue was brought up that we weren’t being paid,” Strickland said.

Just the other day, Strickland got the results of the 4-year audit. Now Medicare is saying patients like Mozingo, don’t need an ambulance to get to dialysis treatment.

Medicare wants Strickland to pay back $370,000 and he has to do it within 60 days.

“I don’t know what’s going to happen,” Strickland said.

== Owner Has No Regrets ==

Strickland told FOX 26 Investigates he doesn’t regret doing the original story and going public with his concerns.

“I’m not sorry, Strickland said. “The thing is: If you don’t bring this information out, what happens is they continue to do what they do without any repercussions.”

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