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Ambulance Company Owners Agree To Pay $6 Million Over Medicare Fraud Allegations

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Source: US Department of Justice

Posted on Monday, December 10, 2007



LAWFUEL - The Legal Newswire - The president of a Los Angeles-based ambulance company, Greybor Medical Transportation, Inc., and his wife have agreed to pay the government $6 million to settle civil allegations that they fraudulently overbilled Medicare. The couple that used Greybor to fraudulently bill the government also have agreed to relinquish their claim to an additional $1 million in suspended payments held by Medicare.

The settlement represents nearly three times the $2.41 million in losses suffered by the government

The settlement resolves allegations made against Boris Shpirt, 53, his wife, Jenny Shpirt, 46, and Greybor in a civil lawsuit filed pursuant to the False Claims Act. The government filed the civil case in 2003, soon after a federal grand jury indicted the defendants on criminal charges. In 2004, Boris Shpirt and Greybor were convicted of multiple counts of health care fraud. Boris Shpirt was sentenced to 108 months in prison and is presently serving his sentence; Jenny Shpirt is currently on supervised release after serving an 18-month sentence (see: http://www.usdoj.gov/usao/cac/news/pr2005/125.html). Boris Shpirt and Greybor were jointly ordered to pay approximately $2.4 million in restitution to Medicare. The civil settlement includes full payment of that criminal restitution.

The False Claims Act lawsuit alleged that between 1998 and 2002 the Shpirts and Greybor regularly submitted claims for ambulance transport to Medicare that falsely stated a patient was “bed-confined,” when in fact the Medicare beneficiary was not. In some cases, patients allegedly bed-confined were actually transported while sitting in the front seat of the ambulance. These false statements allowed Greybor to be reimbursed by Medicare when it was not entitled to receive payment. Medicare will pay for non-emergency ambulance transportation only if no other option is available and only if the patient is bed-confined.

The complaint also alleged that Greybor ambulances were sometimes used to transport four or five patients simultaneously, but Greybor submitted claims to Medicare that falsely indicated the patients Medicare beneficiaries were being transported individually, resulting in higher reimbursement.

The settlement is being paid through the sale of the Shpirts’ Beverly Hills home, which was sold by the government last week for $12.1 million. The remaining proceeds from that sale will be used to pay off the home’s mortgage and various liens, and a small amount will be turned over the Shpirts.

The case was investigated by the Department of Health and Human Services, Office of Inspector General.

CONTACT: Assistant United States Attorney Abraham Meltzer

Civil Fraud Section

(213) 894-7155

abraham.meltzer@usdoj.go

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