The Dallas Morning News
DALLAS — The cash-strapped city of Dallas could owe the federal government $40 million or more if a whistle-blower lawsuit’s allegations of fraud involving billing for ambulance services prove true.
While the city says the specific amount it may owe the government has not been determined, it acknowledges that it is “fully cooperating” with federal authorities and will “move forward aggressively” to make sure any overpayment amounts are repaid.
The previously sealed lawsuit was filed earlier this year by Douglas Moore, a former assistant city auditor. It alleges that Dallas-Fire Rescue officials and the city’s longtime ambulance service billing vendor knowingly collected fraudulent overpayments from Medicare and Medicaid.
According to the suit, the city and Southwest General Services of Dallas billed the government for “Advanced Life Support (ALS) level ambulance services for all 911 calls, regardless of whether the beneficiary’s condition required that level of service.”
The suit alleges that 100 percent of the city’s ambulance calls were billed at the advanced rate - which is more expensive than the Basic Life Support (BLS) level - even though the city’s own documents showed that at least 40 percent of its transport calls should have been billed at the lower cost.
Dallas Fire-Rescue Chief Eddie Burns acknowledged Wednesday that he is aware of the suit but said there is little he can say about it.
“It’s a legal matter, and they’re going to work through it as they would any legal matter,” Burns said. “Both legal teams, the Department of Justice and our legal folks, are trying to seek resolution.”
A one-page statement from the city, first released late Tuesday, says that Southwest General Services has been a vendor for the past 16 years and that the government had only recently indicated that the company, which handles ambulance billing services, had done anything improper.
The city said the amount of overpayments is “believed to be a small percentage of amounts paid under this program to Medicare and Medicaid.”
According to the lawsuit and his attorney, Moore learned of the alleged overpayments last year while doing an audit of ambulance billing services. At an April 8, 2009, meeting, the suits says, he heard a Dallas Fire-Rescue captain say that every ambulance call is billed at the advanced level. A document later produced by another captain showed that 60 percent of the department’s ambulance calls are at the advanced level. A patient requiring advanced services could, for example, need an ambulance equipped to treat a gunshot wound.
Late Wednesday, the city issued an expanded statement saying that “neither the city nor any city official intended to defraud the Federal government.”
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