October 28, 2004 Adventist Health Systems
Adventist Health System Sunbelt Healthcare Corporation, three affiliated hospitals and a management company have agreed to pay over $20 Million Dollars to settle two qui tam actions, one of which was filed by an emergency medical technician, Kevin Mulligan. The allegations were that the defendants overcharged Medicare, by charging for ambulance transports for patients which were not medically necessary. The claims also included allegations that the hospitals created false physician certifications regarding the medical necessity of ambulance transports, and submitted, or caused to be submitted, claims for payment for those transports to Medicare.
Kevin Mulligan, the emergency medical technician who filed one of the qui tam actions was awarded $1.9 Million for having filed the suit. The other relator who filed a qui tam action, Adam Wightman, will receive approximately $500,000 for having filed his case.
See U.S. Dept of Justice Press Release 10/28/04