Justice Department moves forward in its case against ETMC, Paramedics Plus

Source: Roy Maynard, Tyler Morning Telegraph, May 12, 2017

The U.S. Department of Justice continues to build its case against East Texas Medical Center and its ambulance division, Paramedics Plus, in what they say is a $20 million kickback scheme to ensure Paramedics Plus retained lucrative contracts. Most recently, Justice Department attorneys filed a list of people they expect to depose in coming months. In all, more than 100 people could be deposed as this case moves forward. The government also filed a proposed schedule, which outlines when fact discovery will take place, when expert discovery will occur, deadlines for motions and trial preparation and finally, an expected timeframe for the start of the trial – summer of 2018. … In January, the Justice Department announced it would intervene in a lawsuit against ETMC and Paramedics Plus brought by a whistleblower – former employee Stephen Dean, who was Paramedics Plus chief operating officer. According to the suit, ETMC and Paramedics Plus paid more than $20 million in kickbacks and bribes, including cash payments to Oklahoma officials. …

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You Paid For It: Pinellas Commissioners discuss ambulance kickback settlement Tuesday
Source: Mark Douglas, March 21, 2017

Former U.S Attorney Brian Albritton told Pinellas County Commissioners Tuesday that a federal lawsuit alleging ambulance fee kickbacks could have cost taxpayers as much as $1 billion if they lost in court. Commissioners agreed to settle the case involving Paramedics Plus Sunstar ambulance service for $92,700 and to forgo an estimated $500,000 in uncollected ambulance fees from patients. They will also have to pay legal fees to Albritton who the county secretly hired last year to resolve the case. Pinellas commissioners discussed the case publicly Tuesday for the first time since Eight On Your Side first broke the story of alleged kickbacks and a federal investigation of Pinellas County’s ambulance contract last month. That settlement, signed March 7 by Vice-Chair Kenneth Welch, requires the county to pay $92,700 to federal prosecutors, the Florida Attorney General and attorneys for the whistleblower–a former executive with Paramedics Plus. It also requires Pinellas County to turn over all documents and evidence gathered in the course of the county’s own internal investigation, and to cooperate with an ongoing federal investigation and whistleblower action filed against Paramedics Plus in Texas.

… Since 2004, Paramedics Plus has operated as Pinellas County’s exclusive ambulance provider under the county-owned brand name Sunstar. The current county contract with Paramedics Plus amounts to about $50 million a year. In 2014, a former high-ranking executive of Paramedics Plus filed a whistleblower action in Texas that alleged an ongoing ambulance fee kickback scheme that stretched from Pinellas County to Oklahoma and California for over a decade. The scheme alleged by the whistleblower and federal prosecutors in a related legal action included so-called “profit cap” rebates that essentially funneled overcharges from Medicaid and Medicare to Pinellas County and other local governments that oversee public ambulance contracts. County leaders in Pinellas insist the “rebates” or “kickbacks’ in Pinellas totaled only $35,000 or so and ended up in county bank accounts, not someone’s pockets. In Oklahoma, the whistleblower suit alleges those kickbacks amounted to as much as $20 million. Federal prosecutors in Texas have cited specific acts of corruption in Oklahoma that include kickbacks, political payoffs and self-enrichment involving Paramedics Plus executives and government overseers in Oklahoma. … Pinellas County Administrator Mark Woodard says the settlement has no impact on the county’s ongoing $50 million a year contract with Paramedics Plus because the company has not been charged criminally or been found guilty of anything.

Feds Intervene in Alleged $20M Ambulance Kickback Scheme
Source: Eric Topor, Bloomberg BNA, January 27, 2017

A Texas health system paid an Oklahoma agency and its president $20 million in cash bribes in exchange for lucrative ambulance service contracts over 15 years, federal prosecutors said ( United States ex rel. Dean v. Paramedics Plus, LLC , E.D. Tex., No. 14-cv-203, complaint in intervention 1/23/17 ). The U.S. Attorney’s Office for the Eastern District of Texas partially intervened Jan. 23 in a whistle-blower lawsuit, filed under court seal in 2014, accusing East Texas Medical Center Regional Healthcare System (ETMC) of paying the kickbacks to Oklahoma’s Emergency Medical Services Authority (EMSA). Specifically, the government said ETMC concocted the kickback scheme with EMSA president and co-defendant Herbert S. Williamson, and paid the kickbacks through checks, bank wires and inflated service contracts, mostly through ETMC’s ambulance service company, Paramedics Plus LLC. The government said it paid the defendants over $70 million in Medicare reimbursements and over $38 million in Medicaid reimbursements just from 2009 through 2013, and it was seeking treble damages on all payments tainted by the kickback scheme, plus monetary penalties for each individual false claim submitted. The FCA authorizes monetary fines of up to $11,000 for each false claim submission. The U.S. Attorney’s Office declined to comment on whether criminal charges against Williamson would be coming in the future. … The complaint describes how Paramedics Plus, which contracted with the EMSA to provide ambulance services within the EMSA’s jurisdiction, was forced to “cut corners” due to the amount of its revenue that went to paying kickbacks. Paramedics Plus “avoided training and personnel expenses” to make sure enough money was available to pay kickbacks to the EMSA and Williamson, according to prosecutors. The complaint alleges Paramedics Plus executives were forced to forgo paying drivers and paramedics retention bonuses to stem high paramedic turnover because the company “would not have enough excess profits to make [Williamson] whole.”