MetroCare,Metro North Ambulance Scam

[E40FDNYL35]

November 29, 2003 -- The top official of an ambulance company that supplies 10 percent of the vehicles in the 911 system participated in a scheme that defrauded Medicare of $34 million, according to federal authorities.
A civil suit filed by Brooklyn U.S. Attorney Roslynn Mauskopf says three companies run by Steve Zakheim, chief operating officer of MetroCare Ambulance, received millions of dollars from Medicare in the 1990s for transports that didn't qualify for reimbursement.
When auditors asked for the money back, the companies - at Zakheim's direction - obtained documents from hospitals attesting to the medical necessity of the claims.
"Many of these documents were fabricated," the Oct. 30 lawsuit alleged.
One of the ambulance Companies, Metro North, "submitted approximately 143 fabricated letters on St. Barnabas Hospital letterhead that were not signed at all," authorities charged.
Other letters had signatures from other hospitals and nursing homes - which were forged, the lawsuit said.

[kghemtp]

The corporate objectives are what again? Oh yes, MONEY! How about these companies put the care back in healthcare and just do things by the book? This happens so much more frequently than it should, and it drives me further away from private EMS.

[Weruj1]

hasnt this guy been in trouble before ? I thought i recalled reading something about him maybe a few years ago coming under fire for doing something not so nice ...........

[DaSharkie]

This happens so much more frequently than it should, and it drives me further away from private EMS.

A few years ago FDNY had a similar award filed against them for Medicare fraud.

It is not just associated with private EMS providers thank you very much.

[E40FDNYL35]

Originally posted by DaSharkie
A few years ago FDNY had a similar award filed against them for Medicare fraud.

DaSharkie when was that.I asked around and nobody remembers that.
;) Are you sure it wasn't Health and Hospitals?

[kghemtp]

Oh no no... I wasn't trying to dig into privates. I've had bad experiences and this just doesn't help any. It would be like any firefighter or EMT making a bad name for others in the profession. Whether private, municipal, or whatever, negative publicity is earned for the collective whole. I'm certainly Pro- whatever works for your town/city/state/province.

[DaSharkie]

E40,

I twas listed in Jems within the past 2 to 3 years. Having been shortly after the merger of H&H and FDNY many of the cases may have been from the pre FDNY days. I shall try to find additional info.

KGHEMTP,

I did not take it as a personal dig. My skin is too thick for that. My point was that fire departments, city, county and private EMS all get whacked with fraud. Most times it is unintentional BUT every once in a while some jerkwad comes up with a way to screw the system. Unfortunately, it is usually a private service and it is the crews who get hurt becuase of the penalties.

E40,

After some research I have found this site:

http://www.ecnalubma.com/ems.pdf

Go to page 8 and it mentions the madicare fraud lawsuit. More info pending.

BTW - I am not beig critical of hte FDNY, I just don;t want anyone to think that I made up my statement.

[E40FDNYL35]

Just a note here FDNY merged with Health and Hospitals on March 17, 1997.

EMS ambulance billing for Medicare was suspended for approximately two
calendar years, in 1997 and 1998, as a result of a Medicare lawsuit charging improper billing. The suit was settled in October 1998, and New York City and FDNY entered into a billing compliance agreement with Medicare for the subsequent five year period....

So it was a HHC problem which FDNY fixed.;)

[Weruj1]

I knew that looked familliar ..............wow I am surprised the ol brain could remeber something like that.