Attorney General Chris Carr Announces Medicaid Fraud Settlement With United States Attorney for the Middle Disctrict of Georgia
Attorney General
"Enforcement of the Georgia False Medicaid Claims Act is a top priority for our office," said
Navicent agreed to pay to
The settlement marks the end of a 27-month investigation into Navicent's ambulance billing practices, revealing two suspected schemes through which Navicent allegedly violated the False Claims Act and the Georgia False Medicaid Claims Act. The first alleged scheme resolved by the settlement concerns non-emergency ambulance transports between hospitals that Navicent billed at an inflated rate by claiming the ambulance trips were emergency trips. The second alleged scheme resolved by the settlement concerns the billing of non-emergency ambulance transports of patients released from the hospital to their residences, skilled nursing facilities, hospital-based diagnostic clinics, or dialysis centers that Navicent billed as emergency transports in violation of ambulance billing rules. It was alleged that in addition to billing many of these transports at an inflated rate, for many of these transports it was neither appropriate nor medically necessary for Navicent to have used and billed for an ambulance at all.
This investigation began with a lawsuit filed by
While
As a result of this investigation, on
"Ambulance billing has long been an area of potential fraud on the Medicare and Medicaid programs and this office will continue to vigorously investigate and pursue those who attempt to take advantage of the program. We will continue to police ambulance providers throughout
"Since Navicent owned and operated both the hospital and ambulances, profits from the systemic, deceptive practice of falsifying 'emergency' trips would fatten the hospital's bottom line," said
The case was investigated by the
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