Ambulance Company Defrauds Medicare

Ambulance Company Defrauds Medicare

by Angela Bass, February 8, 2016

You never want to be that driver that takes forever to move over when the sirens of a hurried ambulance are fast approaching in your rearview. Our first responders need us to move and think quickly in those crucial moments. Someone else’s life could be hanging in the balance. And most of us are able to react quickly and get back on the road without missing a beat.

But what about the scam artists who might be driving those ambulances?

Come again?

Switching gears

If it wasn’t for the $1.5 million in fraudulent Medicare claims made by ProMed Medical Transportation, a Southern California ambulance company, then this article could continue to focus on the importance of clearing the way for emergency vehicles.

But thanks to the company’s owner, managers and operator, our Asurea Scam Report is switching gears. When an ambulance company defrauds Medicare, it’s important to inform taxpayers like you who make Medicare possible of how this healthcare safety net is being abused.

Putting on the brakes

Exactly how did this ambulance company defraud Medicare? Well, its drivers rushed mostly dialysis patients with Medicare benefits to the hospital when it wasn’t necessary. And they billed Medicare for the rides. The crooks got away with this scheme from May 2008 to October 2010.

In those two-plus years, ProMed submitted at least $1.5 million in fake claims to Medicare for falsified transportation services. And Medicare paid out the big bucks — at least $804,755 — on those false claims. The scammers even told ProMed EMTs to hide each patient’s true medical conditions by falsifying paperwork and creating fake documents to justify the services.

We have to say, it takes some clever, con-artist masterminding to defraud Medicare. But it unfortunately happens all the time. Fortunately, officials with the Justice Department’s Criminal Division, the Central District of California, the U.S. Department of Health and Human Services, and the FBI’s Los Angeles Division put the brakes on this scheme.

Going nowhere fast

Going to prison is not what the con artists had in mind. But that’s where they went.

The ringleader was sentenced to 108 years in prison. He is 47-year-old Yaroslav Proshak, aka Steven Proshak, of Valley Village, California. A judge sentenced others involved in the scam to as many as 36 months. The scammers were also ordered to pay restitution in the amount of $804,755. All three scammers were convicted of five counts of health-care fraud and one count of conspiracy to commit health-care fraud.

Someday, someway, somehow

Along with other agencies, the FBI investigated the case as part of the Medicare Fraud Strike Force. The Medicare Fraud Strike Force is supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office of the Central District of California. The moral of this story is that when you commit Medicare fraud, you are bound to get caught someday, someway, somehow.

To learn more about the Health Care Fraud Prevention and Enforcement Action Team, aka HEAT, visit www.stopmedicarefraud.gov.

 

 

For more articles on insurance scams

Skim our Asurea Scam Report for tips on how to avoid being scammed.

 

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This information is provided for general consumer educational purposes only and is not intended to provide legal, tax or investment advice.

 

Angela Bass

Angela Bass

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Angela joined Asurea as the Content Marketing Writer in September 2015. She is also a freelance multimedia journalist, having written and produced stories for Land & People Magazine, The Baltimore Sun, California Health Report, NPR's Latino USA, PRI's The World and KALW's Crosscurrents, among others. In 2014, she founded Storybrook Media, which provides video production services to nonprofits and small businesses. She holds a Master’s in Journalism from UC Berkeley and a BA in Creative Writing from San Francisco State.
Angela Bass