Texas Ambulance Owners Indicted for Dialysis Patient Billing Fraud

[Zach]

   
News » News News
http://www.theexaminer.com/npps/story.cfm?ID=3016

Feds unseal 75-count indictment against Priority 1 EMS Jasper owners
BREAKING NEWS!!!
By Jerry Jordan, News Editor

The U.S. District Attorney Office for the Eastern District of Texas has unsealed a 75-count indictment against Robert and Claudette Read, the owners of Priority 1 EMS in Jasper, The Examiner Newspaper has learned.

A copy of the 31-page indictment alleges that over the course of a three-years period from 2004 to 2007, the Reads conspired and committed health care fraud and mail fraud. The indictment lays out the alleged scheme in a 24-paragraph synopsis claiming the Reads illegally received about $1.75 million in fraudulent payments for billings to Medicaid, Medicare and to Blue Cross and Blue Shield.

In short, the ambulance company is alleged to have submitted fraudulent records for reimbursement for patients that failed to meet the legal criteria as being non-ambulatory and needing transportation to and from area dialysis centers for treatment via an ambulance when they should have been transported by other means. Medicare, Medicaid and Blue Cross and Blue Shield of Texas do not reimburse transport fees for ambulatory patients. But transportation cost are reimbursed at a rate of about $400 per trip for patients that do meet the requirements. It is alleged the Reads falsified the billing statement to obtain reimbursements they were not entitled to.

A very polite woman who was answering the phones for Priority 1 in Jasper said the Reads were not in the office and that she would take a message and inform them that their comments were being sought for this article.

If convicted, the Reads cold each receive up to 10 years in federal prison for each of the health care fraud charges and up to 20 years in federal prison for each of the mail fraud counts. Additionally, there is a possible fine of up to $250,000 for each count listed in the indictment.

The Reads made their initial appearance with their attorney, on Monday, March 23, in front of U.S. Judge Judith Guthrie in Tyler. They both waived formal arraignment, pleaded “not guilty” and were released after posting a PR bond.