Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme

Guam Ambulance Company Owners Sentenced to Prison for Their Roles in Medicare Ambulance Fraud Scheme.

Two owners of Guam Medical Transport (GMT) were sentenced to prison terms today for their roles in a health care fraud and money laundering scheme that resulted in a loss to the United States of approximately $10.8 million, one of the largest single Medicare ambulance fraud cases ever prosecuted by the Justice Department.

Assistant Attorney General Brian A. Benczkowski of the Justice Department’s Criminal Division, U.S. Attorney Shawn N. Anderson of the Districts of Guam and the Northern Mariana Islands, Special Agent in Charge Eli S. Miranda of the FBI’s Honolulu Field Office, Special Agent in Charge Justin Campbell of IRS Criminal Investigation (IRS-CI) Seattle Field Office and Special Agent in Charge Timothy DeFrancesca of the U.S. Department of Health and Human Services Office of the Inspector General (HHS-OIG) Los Angeles Regional Office made the announcement.

According to their admissions at the plea hearing, from approximately March 11, 2010, to approximately March 21, 2014, the defendants engaged in a conspiracy to defraud Medicare and TRICARE by submitting claims for reimbursement for medically unnecessary ambulance services that GMT provided to patients with ESRD.

As part of the scheme, the defendants directed GMT employees to remove from internal documents references to GMT patients’ ability to walk because they knew that Medicare and TRICARE would not provide reimbursement for the patients.

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