An Ellsworth-area ambulance service has settled a civil suit brought by prosecutors who charged it with filing false reimbursement claims.
County Ambulance, Inc., has agreed to pay $16,776.74 to resolve allegations that it submitted false claims to Medicare and MaineCare from January 2015 through April 2016, the U.S. Attorney’s Office wrote Tuesday in a prepared statement. About two-thirds of all claims submitted to MaineCare, which is Maine’s Medicaid program, are paid for by the federal government.
According to federal officials, County Ambulance used reimbursement funds paid through the two programs to pay the salary and benefits of a County Ambulance employee who had been excluded from the programs. Information about how reimbursement funds can and cannot be used are readily available on state and federal health department websites, they wrote.
The employee, who was working part time in the company’s Ellsworth office as an administrative assistant, had been a pharmacy technician who surrendered her license in 2013 after what prosecutors described as “a diversion of controlled substances,” which excluded her from being eligible for participating the reimbursement programs. Over a period of 16 months, County Ambulance had paid roughly $13,750 to the employee.
Prosecutors said the employee’s name is among discipline cases listed on the state’s Board of Pharmacy website, which is another reason why County Ambulance should have known her wages were not reimbursable through Medicaid and MaineCare.
The employee was not identified in court documents. Several names come up among search results in the board’s online disciplinary database for former pharmacy technicians who lost their licenses in 2013.
“County Ambulance acted with deliberate ignorance and/or reckless disregard of these material facts by neglecting to perform any search of the individual across these exclusion databases and publicly available resources,” prosecutors wrote in the civil complaint.
John Partridge, the head the company, said Tuesday evening that he doesn’t dispute the prosecutors’ description of the basic facts of the case.
“It was an oversight, is what it was,” Partridge said of the ineligible reimbursements. “Everything is fine now.”
He declined to comment further.
County Ambulance cooperated throughout the investigation, prosecutors said.
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