Health Provider, The Medical Center, Navicent Health to Pay Over $2.5 Million to Settle Medicare and Medicaid Fraud Allegations
The United States Department of Justice announced today that Macon, Georgia based health provider, The Medical Center of Central Georgia, Inc. d/b/a The Medical Center, Navicent Health (“Navicent”) has agreed to pay $2,549,742 to settle allegations concerning the billing of ambulance services. The settlement arises from a complaint filed pursuant to the False Claims Act and Georgia False Medicaid Claims Act by whistleblower Andre Valentine in the United States District Court, Middle District of Georgia, United States and The State of Georgia ex rel. Andre Valentine v. Navicent Health, Inc., Civil Action No.: 5:15-CV-152 (M.D.Ga.). Andre Valentine is represented by Kevin Doyle of Lokey, Mobley and Doyle, LLP.
In this case, the United States and the State of Georgia contended that Navicent upcoded non-emergency hospital-to-hospital ambulance transports as emergency transports in claims submitted to Medicare and Medicaid; upcoded non-emergency ambulance transports from the hospital to patients’ residences, nursing homes, skilled nursing facilities, hospital-based diagnostic clinic, or dialysis clinics as emergency transports; and, submitted claims to Medicare and Medicaid for medically unnecessary ambulance transports of patients from the hospital to patients’ residences, nursing homes, skilled nursing facilities, hospital-based diagnostic clinic, or dialysis clinics.
Andre Valentine and Lokey, Mobley and Doyle express their appreciation and gratitude to Assistant United States Attorney Todd P. Swanson and the attorneys and investigators of the United States Attorney’s Office for the Middle District of Georgia, to Assistant Attorney General Elizabeth White and the attorneys and investigators for the Georgia Attorney General, Georgia Medicaid Fraud Control Unit, and to the investigators of Health and Human Services, Office of Inspector General for their hard work, which culminated in this excellent result.