Carl Crawley filed a lawsuit in 2009 alleging that he witnessed “widespread, systematic” Medicare fraud “on a daily basis” while working for Rural/Metro of Central Alabama, the Bessemer subsidiary of Rural/Metro Corp. of Scottsdale, Ariz. The whistleblower’s lawyers and federal prosecutors announced last month that the Medicare fraud suit against the multistate ambulance company had been settled with the company’s agreement to pay more than $5.4 million to settle. Joyce White Vance, U.S. Attorney for the Northern District of Alabama, had this to say in a statement:

The resolution of this lawsuit means millions of taxpayer dollars that were used to reimburse false claims by Rural/Metro’s ambulance service have been recovered.

In 2011, the U.S. Attorney’s office filed a complaint to intervene in the whistleblower suit. The settlement concerns allegations in Alabama, Kentucky and Tennessee. Rural/Metro Corp., which operates in 20 states, admitted no wrongdoing as part of the settlement. Mr. Crawley had filed the qui tam complaint, a lawsuit on behalf of the whistleblower and the government, alleging wrongdoing by his employer in the company’s performance of a government contract or regulation. It has been pointed out that “if it hadn’t been for Mr. Crawley bringing this matter to the government’s attention, the government would not have known about the fraud in these other areas as well.” That’s always the case in whistleblower litigation.

The U.S. Department of Health and Human Services aided in the investigation. The lawsuit involved reimbursements for ambulance trips by dialysis patients in several states. It was contended that Rural/Metro filed bills falsely claiming that the patient either was confined to bed, or the ambulance trip was medically required. It was alleged in the complaint:

Medicare and Medicaid would not have paid these claims if they had known that the patients’ conditions did not meet Medicare and Medicaid’s requirements for reimbursement of ambulance transportation.

The settlement only resolves the civil lawsuit, and does not affect any federal tax or criminal liability, according to the agreement. Crawley, who worked for the ambulance company in 2008 and 2009, now is pursuing a criminal justice degree in college. Birmingham lawyers Henry Frohsin and Jim Barger represented Mr. Crawley, the whistleblower in the lawsuit, and they did a very good job.

Source: The Birmingham News

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