A group of small-town ambulance volunteers face a federal prosecution. New charges claim that the group enriched itself by submitting fraudulent billing for unnecessary services. The team of volunteers allegedly defrauded Medicare of around $880,000.
Prosecutors became suspicious when they noticed how much money the group's president earned from the ambulance operation. When they began investigating the volunteer squad, they found that the group billed Medicare for more than 1000 suspicious miles between 2005 and 2011. The ambulance team billed all of these miles from the homes of only three patients.
Although Medicare covers ambulance trips, it does so only when a patient is bedridden and unable to transport him or herself. But when investigators tailed the ambulances, they saw the three patients walking out of their homes and into the ambulance where they laid down on a gurney for the ride.
The government actively investigated the group since at least 2008. In cases like this, it is common for investigators to spend years gathering evidence while they allow the suspect to keep working. A defendant could spend years digging a deeper hole before realizing that he or she is the subject of an investigation and will be subject to an impending criminal case. By the time prosecutors choose to bring a case, they will usually have amassed a strong body of evidence, making a successful conviction much more likely.
Source: The Roanoke Times, "Health care fraud case in Western Virginia in part of a nationwide crackdown," Laurence Hammack, Sept. 9, 2012