An Oklahoma ambulance service provider will pay $300,000 to settle a whistleblower lawsuit alleging it violated the federal False Claims Act and Anti-Kickback Statute by engaging in an unlawful kickback scheme with a former Texas contractor.
According to Tulsa World, a whistleblower lawsuit provided the basis for allegations lodged by federal officials. The complaint alleged that Emergency Medical Services Authority (EMSA), its former president and CEO Stephen Williamson, and contractor Paramedics Plus LLC controlled a slush fund that they used to pay out more than $20 million in kickbacks, including $50,000 or more for Mr. Williamson’s personal benefit.
The State of Oklahoma later joined the U.S. in the lawsuit to recover its portion of Medicaid funds lost to the alleged scheme.
The U.S. government prohibits health care providers from using kickbacks and other inappropriate financial arrangements to boost profits at the expense of Medicare, Medicaid, and other taxpayer-funded health care programs.
A company or other entity that bills these public programs when not in compliance with the federal rules and regulations governing them may be found, under the law, to be submitting false claims to the government.
Federal prosecutors alleged that the defendants submitted false claims to Medicare and Medicaid that resulted in at least $109 million in “tainted reimbursements” from 2009 to 2013, according to Tulsa World.
According to Tulsa World, the federal lawsuit against EMSA, Paramedics Plus, and the other defendants was filed by Stephen Dean under the whistleblower provisions of the False Claims Act, which permit private parties to file suit on behalf of the U.S. government in cases of fraud targeting taxpayer-funded programs and agencies.
Paramedics Plus and its parent company East Texas Medical Center Regional Health Services Inc. (ETMC), reached a settlement in principle with the U.S. Feb. 28. The details of that deal were not made public, but a source told Tulsa World that ETMC agreed to pay the government $20 million.
EMSA and Paramedics Plus are now suing each other over attorney fees and other costs they racked up defending themselves against the whistleblower allegations, Tulsa World reported.