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False claims submitted by Iowa ambulance driver to cost company big

CEDAR RAPIDS – Siouxland Paramedics, Inc. (SPI), a provider of ambulance services to Sioux City area residents, has agreed to pay $390,000 to resolve allegations that it violated the Federal False Claims Act and the State of Iowa False Claims Act. The United States and the State of Iowa contend that SPI “upcoded” claims submitted to both the Medicare and Medicaid programs for ambulance transports. SPI fully cooperated with the investigation and by settling did not admit to any wrongdoing or liability.

“SPI’s cooperation in the investigation is appreciated and acknowledged,” said Matt Cole, the Civil Chief for the United States Attorney’s Office for the Northern District of Iowa. “It is important that, when accusations of wrongful overpayment arise, providers comply fully with our office’s investigation into overpayment allegations. We are dedicated to ensuring that all charges submitted to both the Medicare and Medicaid programs fairly and accurately correspond to the services provided.”

The state’s Medicaid Program Integrity Unit initiated the investigation. False Claims Act cases also arise under the qui tam, or whistleblower provision of the Federal False Claims Act. Under those provisions, a private party may file suit upon behalf of the United States for false claims and share in any recovery.

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