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 experienced in litigating ambulance fraud cases, including the ongoing partially intervened case, United States ex rel. White v. Mobile Care EMS & Transport, Inc., et al., No. 1:15-cv-555 (S.D. Ohio). If you observed ambulance fraud or other healthcare fraud, please contact us.