The former owner of ambulance company and an employee face up to 10 years in prison and possibly $500,000 in total fines after pleading guilty to a $6.1 million Medicare scheme.
Davon Henderson and Pamela Babb each pleaded guilty to conspiracy to commit healthcare fraud and aggravated identity charges Friday, Bloomberg Law reported.
Henderson is the former owner of Med 1 Inter-facility Care LLC, a now closed ambulance service provider that was based in Greenville, NC, while Babb was a former employee.
The scheme ran from 2014 to 2016 and involved the two pretending to be Humana beneficiaries and billed fictitious ambulance services to its Medicare Advantage plan. They billed $6.1 million in fraudulent services during that time period and Humana paid $4.7 million for those services.
The pair face up to 10 years in prison and $250,000 in fines for the fraud charges and two years in prison and $250,000 in fines for the identify theft charges, the report stated.
Medicare payments for ambulance transport services have recently been a focus of the federal government, and skilled nursing providers may want to use caution when considering some companies.
An Office of the Inspector General report estimated that Medicare incorrectly paid nearly $850,000 for emergency ambulance transports from hospitals to skilled nursing facilities.
The federal watchdog recommended that the Centers for Medicaid & Medicare Services develop a fraud prevention model in response to the report’s findings.
