According to the Inspector General of the Department of Health and Human services, Medicare paid $30 million for phantom ambulance rides for which no record exists on the runs. The Inspector’s audit also discovered that some urban ambulance services got paid for an average distance of more than 100 miles per ride. That contrasts with a national average of just 10 miles for urban ambulance rides.
Four major metro areas appear to have the most ambulance billing schemes. Philadelphia, Los Angeles, New York and Houston accounted for about half of the questionable rides and payments. Medicare has barred new ambulance companies from joining the program in Houston and Philadelphia, and the report recommends a similar approach in certain other places.
Across the country, 1 in 5 ambulance companies had at least some questionable billings.
“Medicare payments for ambulance transports have increased in recent years, and investigators have uncovered a variety of fraud schemes involving ambulance suppliers,” the report said.
The audit involves medical claims dating to the first six months of 2012, but the inspector general’s office said it believes the findings reflect continuing weaknesses in Medicare’s efforts against fraud. A Medicare spokesman says the agency has taken action since the auditors privately shared their findings last year.
Medicare has always had a problem with ambulance fraud. Over the past decade the total cost of ambulance rides has risen sharply. Medicare’s Part B, which covers outpatient care, paid $5.8 billion for ambulance rides in 2012, almost double the amount paid in 2003.
Jeffrey Newman represents whistleblowers.