False insurance claims alleged against ambulance companies owned by Mattapoisett resident settle for $1.6 million
DARTMOUTH — A Dartmouth-based ambulance service and emergency medial service, owned by Mattapoisett resident Carol Mansfield, will pay $1.6 million after reaching a settlement with the state attorney general’s office, according to a press release from Attorney General Andrea Campbell.
Mansfield owns STAT Ambulance Services, Inc. and Southcoast Emergency Medical Services, Inc.
The Attorney General’s Office contends that since at least January 2015, the Dartmouth companies falsified and “upcoded” their claims to MassHealth by purposefully miscoding their rendered services to file more expensive claims. For example, the companies billed for emergency services when only nonemergency services were provided. The office also contends that the companies billed for advanced ambulance services when only basic ambulance services were provided.
The office also alleges that the companies billed MassHealth for medically unnecessary services, instructing employees to falsify documents to support “upcoded” claims to MassHealth, and that the companies failed to comply with MassHealth’s requirements regarding medical necessity forms for nonemergency transportation services. In addition, the office alleges that Southcoast Emergency Medical Services did the same with Medicare, a federal service.
In addition to the settlement, STAT and Southcoast have also agreed to retain an independent compliance monitor and to implement company-wide training and auditing to ensure future compliance with all state and federal laws and regulations, according to the Attorney General’s Office.
STAT Ambulance Services and Southcoast Emergency Medical Services could not immediately be reached for comment.