Feds Make Gains Against Ambulance Fraud in Philadelphia Area

A moratorium on new ambulance companies becoming eligible for Medicare payments has appeared to cut ambulance fraud in the Philly area.

The federal government has been cracking down on ambulance overcharging this year in Philadelphia. It’s only the second-ever crackdown in the nation, after Houston.

Because Philadelphia has such a large aging population, carriers attempt to overcharge Medicare for repeated, perhaps unnecessary ambulance trips. (Some carriers even go so far as to, for example, pay seniors to take an ambulance to the hospital for dialysis instead of walking.) Since February, new ambulance operators in the Philadelphia area have been barred from becoming eligible to receive Medicare payments. This prevents blacklisted carriers from shutting down and reorganizing instantly.

The average Medicare payment per patient in comparable areas is $803; Philadelphia area ambulance companies billed an average of $1,314. The Inquirer’s Alfred Lubrano details some of the costs, with examples of one ambulance company in good standing and one that billed taxpayers much more:

  • EMStar (good numbers!): 8,288 patients, $3.96 million, $477 per patient
  • Midlantic Medical Transport (now defunct): 44 patients, $1.7 million, $39,366 per patient

Vincent Dispoto, listed as the company’s landlord and owner, told the Inquirer that “I never had anything to do with the management or day-to-day operations of any ambulance company. I am not an EMT.”

[Inquirer]