Case Summary

Medicare and other Government-funded insurance cover ambulance transportation when it is medically necessary, when other forms of transportation are contraindicated, and when other Government requirements are satisfied. Medicare will not pay for ambulance transportation provided solely for the convenience of a patient’s caretakers. Nor will Medicare pay for ambulance services billed at a higher rate of service than was provided or than was medically necessary.

“Medicare will not pay for ambulance transportation provided solely for the convenience of a patient’s caretakers.”

For example, Medicare will not pay for nonemergency ambulance transports of dialysis patients when the patients are ambulatory or are not bed-confined. Nor will Medicare pay for ambulance transport at the higher ALS rate when no medically necessary ALS intervention was provided and when the call was not dispatched at the ALS level pursuant to a standard dispatch protocol.

Our attorneys are among the counsel for the relators in United States ex rel. Vassallo et al. v. Rural/Metro Corporation et al., No. CV-15-00119-PHX-SRB (D. Arizona), a case which alleges certain ambulance billing improprieties.

TYPE

False Claims Act Healthcare Fraud

CASE

United States ex rel. Vassallo et al. v. Rural/Metro Corporation et al

CASE NO.

CV-15-00119-PHX-SRB (D. Arizona)

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