BOSTON – The Massachusetts Attorney General’s Office has announced a six-million-dollar settlement with ambulance companies Brewster Ambulance and EasCare to resolve allegations that the companies and owners submitted false claims to MassHealth for more expensive services than were provided.
The state also alleged the Weymouth-based companies owned by Mark Brewster and George Brewster, Jr. violated MassHealth medical necessity requirements, and failed to disclose relevant information when submitting the companies’ applications to serve as MassHealth providers.
Brewster Ambulance and EasCare will implement a three-year compliance monitoring program, which will include updated policies and procedures, training requirements, and annual site and records audits, the results of which will be reported to the Attorney General’s Office.
From the A.G.’s office:
Per its investigation, the AGO alleged that Brewster and EasCare fraudulently “upcoded” their claims to MassHealth by billing for more expensive levels of services than they actually provided or required, including billing for emergency services when only non-emergency services were provided or required.
Additionally, the AGO alleged that the companies fraudulently billed MassHealth for medically unnecessary services and/or for nonemergency services without maintaining relevant medical necessity documentation, as required by MassHealth.
Furthermore, in violation of MassHealth medical necessity requirements, the AGO alleged that Brewster and EasCare also requested medical authorization signatures from providers without presenting relevant and completed medical necessity documentation as required.
Additionally, the AGO alleged that when submitting their MassHealth provider applications, Brewster and EasCare failed to disclose to MassHealth relevant information concerning owners, managers, and employees of the companies.
The AGO asserted that this conduct constituted violations of various state laws, including the Massachusetts False Claims Act. These allegations were first uncovered through a whistleblower lawsuit filed in the District of Massachusetts.
The companies provide ambulance and wheelchair transportation services to MassHealth patients across the Greater Boston and South Shore areas. Collectively, they are the largest medical transportation provider in Massachusetts.
“When companies violate our laws and defraud the MassHealth program, crucial taxpayer resources are misdirected from paying for health care for those who need it most,” said Campbell. “I am proud to announce this settlement, which will provide meaningful restitution to the Commonwealth and ensure compliance with laws that enable the MassHealth program to serve the millions of residents who depend on it for their healthcare needs.”
By Jim McCabe, CapeCod.com NewsCenter
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