Boston's ambulance companies STAT Ambulance Services, Inc. and Southcoast Emergency Medical Services, Inc. have reached a hefty $1.6 million settlement over allegations of false billing, as confirmed by Attorney General Andrea Joy Campbell. Owned by Carol Mansfield, these companies have had to face the music for fleecing MassHealth, the state's Medicaid program, and to a lesser extent, Medicare.
Owned by Carol Mansfield of Mattapoisett, who might need a lesson in honesty, STAT and Southcoast have been doing more than just transporting patients. They've been accused of "upcoding" since at least January 2015, a shady practice of inflating their service charges by miscoding the type of services provided, revealed in a press release from the AG's office. These companies took a ride on the taxpayers' dime, billing for advanced services when delivering only basic ones, and even went so far as charging for emergencies when there were none.
"When providers fail to comply with MassHealth regulations, the program suffers," said AG Campbell, presumably irked by the dishonest practices. Her statement, obtained by the Mass.gov newsroom, underscored her team's dedication to the integrity of MassHealth, which ensures critical support for Massachusetts' most vulnerable citizens.
In addition to returning the wrongly claimed $1.6 million, STAT and Southcoast, having manipulated service documentation according to allegations, have promised to clean up their act. They've agreed to let an independent compliance monitor whip them into shape and will put their entire staff through training to ensure they stick to state and federal guidelines going forward. But, billing MassHealth for medically unnecessary services, their employees were instructed to fake documentation, as alleged by the AG's office.
This marks another victory in AG Campbell's crusade against health care fraud, following a $2.6 million win back in August 2023 against MedStar Ambulance, Inc. Meanwhile, the team behind this crackdown, comprised of Assistant Attorney General Kevin O'Keefe, Senior Trial Counsel Elisha Willis, and more, as noted in the press release, continue their relentless pursuit of health care justice.
The efforts to root out Medicaid fraud in Massachusetts, partly funded by a grant from the U.S. Department of Health and Human Services, prove that the AG's Medicaid Fraud Division means business, with the U.S. Department of Health and Human Services providing substantial assistance in this investigation, as reported on the Mass.gov website.
