Excluded Ambulance Drivers: Whose Responsibility?

Posted by Frank Strafford on September 7, 2015 in Exclusion Screening, Exclusions, Industry News, OIG Penalties,

Four Jacksonville, FL hospitals have agreed to pay a combined $7.5 million settlement for crimes that they did not commit.

Excluded Ambulance Drivers in Jacksonville: Whose Responsibility?Jacksonville Business Journal reports that the four — Baptist Health, which runs four hospitals; UF Health Jacksonville; Memorial Hospital, which runs two hospitals; and Orange Park Medical Center — all employed the services of Century Ambulance.  Federal prosecutors opened litigation against the four upon discovering that Century submitted claims for transports on life support ambulances, for non-emergency transports.

Although the hospitals did not receive any financial gain from the claims; and although they do not admit to any wrongdoing; they have chosen to pay out the settlement, rather than face the notoriety and cost of litigation.

That makes us worried.

To quote Timothy Powell, a Florida healthcare consultant who addressed the issue in his post Ambulancegate: This should scare you:

It seems in this case that the government is attempting make the argument that hospitals and nursing homes are somehow contractors or grantees of the ambulance companies billing for services, even if they are not billing the services. It’s more than just an issue of forcing hospitals and nursing homes to be responsible for billings they did not submit for services they did not provide; and it presents a slippery slope leading to other potential problems.

Powell suggests checking the exclusion database to ensure that you don’t inadvertently partner with a bad actor.  But beyond that, he seems to be resigned to the situation.  The Feds have taken a stand, and they don’t seem likely to change their minds any time soon.

On a similar note, attorneys Page, Wolfberg and Wirth posted an advisory on EMS1.com, warning EMS companies to keep a running check of the exclusion list when employing or contracting with individuals or companies.  Because indeed, you CAN get penalized for contracting with or employing an excluded individual or company; even if your organization didn’t do the billing, or gain any benefit at all.  In all likelihood, the Jacksonville hospitals had no idea that Century was submitting inflated claims; the patients came, the hospitals treated them, and that’s all there was to the story – at least as far as the hospital was concerned.

For our part, we’re recommending that our clients take the safe route, by routinely screening all of their vendors.  Considering the fact that our software does that automatically, it certainly seems simpler than getting involved in litigation.  And an awful lot cheaper than a $7.5 million settlement.

About Frank Strafford

About Frank Strafford

Related Articles

Jimmy Kimmel Monologue Inspires National Nurses ...

May 9, 2017

Late night television host Jimmy Kimmel tearfully told the story of his newborn son’s recent birth and open-heart surgery due to a heart defect. In his monologue, Kimmel explained that it was an att...

Is Your Partner Excluded? Doctors, Take ...

July 13, 2015

  An attorney with HHS’ Office of Inspector General said Thursday that the OIG is hiring additional lawyers to look into taking more administrative actions against doctors. They're looking for the...

The Symbiotic Relationship of Federal and ...

September 5, 2022

Healthcare professional licensing and certification is controlled by states and local jurisdictions.  All healthcare professionals must apply for licensure by the state (s) in which they intend t...

Understanding OIG Exclusions

OIG Exclusions Screening Process

Exclusion FAQS

Quick OIG Exclusion Basics

Employing Excluded Individuals

Consequences to Employing an Excluded Individual

OIG Compliance Law

Laws and Publications on OIG Compliance

More Compliance Resources

The Verify Way!

We build the best, so you can perform at your best.

Trusted for Good Reason

  • ✓ Guaranteed accurate
  • ✓ Certified Secure
  • ✓ Audit Proof
  • ✓ Feature-rich reporting
  • ✓ Round the clock real-time-data
  • ✓ Processing fully automated

Security First

  • ✓ Cloud hosted
  • ✓ Encrypted data
  • ✓ Real-time backups

Trusted for Accuracy

  • ✓ Physical security
  • ✓ Restricted access
  • ✓ Single sign-on
  • ✓ Password security
  • ✓ Certified secure
  • ✓ Cross checking

HEALTHCARE ESTABLISHMENTS NATIONWIDE COUNT ON STREAMLINE VERIFY

5

60%

Average workload reduction by implementing the Streamline Verify program

5

10K

Establishments trust Streamline Verify nationwide

5

2011

Serving the healthcare industry’s unique compliance needs since 2011

5

24X

Setting standards with hourly synchronization to primary source data

[class^="wpforms-"]
[class^="wpforms-"]