An employee who filed a whistleblower lawsuit against his former employer, Hart to Heart Ambulance Service, alleging the company engaged in fraudulent Medicare billing schemes to boost profits, has helped the U.S. to recover $1.25 million.

The U.S. Attorney’s Office in Baltimore said that Bryan Arvey filed the lawsuit against the Forest Hill, Maryland-based ambulance company under the whistleblower provisions of the False Claims Act. The federal law allows individuals and other private parties to sue on behalf of the federal government when they have evidence of fraud committed against U.S. agencies and programs.

Specifically, the whistleblower complaint alleged that Hart to Heart and its billing affiliate EMS Billing Solutions Inc., along with the owners and operators of both companies, received millions of dollars from Medicare for ambulance rides that were not medically necessary.

Medicare requires that a patient’s medical condition should be such that ambulance transportation is medically necessary as opposed to other forms of transportation. The U.S. Attorney’s Office for the District of Maryland said that Hart to Heart submitted a high rate of ambulance claims for patients who could have been transported by wheelchair van or other means.

Federal prosecutors said that the whistleblower complaint cited numerous former Hart to Heart employees who claimed the company’s managers pressured them into falsifying documentation to make Medicare reimbursement more likely.

The government investigated Mr. Arvey’s whistleblower allegations and chose to intervene in the case. According to the government, Hart to Heart knowingly submitted fraudulent claims to Medicare for non-emergency ambulance transportation, such as trips to a clinic for dialysis or ride home after hospital discharge over a period of several years, starting Jan. 2, 2010, to Dec. 31, 2017.

According to the U.S. Attorney’s Office, Hart to Heart, which does business as Hart to Heart Transportation Services, agreed to settle the case for $1.25 million but did not admit liability.

“When health care providers participate in fraudulent billing schemes in order to increase profits, they steal from the pockets of the taxpayer and jeopardize federal health care programs,” said Maureen Dixon, Special Agent in Charge for the Office of Inspector General of the U.S. Department of Health and Human Services. “We will continue to be relentless in our efforts to hold such providers accountable.”

Mr. Arvey will receive a whistleblower award of $251,000 – about 20% of the total recovery – for helping the U.S. recover Medicare funds from Hart to Heart.

Whistleblowers are the key to exposing corporate wrongdoing and government fraud. A person who has first-hand knowledge of fraud or other wrongdoing may have a whistleblower case. Before you report suspected fraud or other wrongdoing – before you “blow the whistle” – it is important to make sure you have a valid claim and that you are prepared for what lies ahead. Beasley Allen has an experienced group of lawyers dedicated to handling whistleblower cases. The lawyers on our firm’s Whistleblower Litigation Team are Archie Grubb, Larry Golston, Lance Gould and Paul Evans. These lawyers will be glad to discuss any potential whistleblower claim either in person or by phone.

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