Pennsylvania Ambulance Company Pleads Guilty to Medicare Fraud - News - @

Pennsylvania Ambulance Company Pleads Guilty to Medicare Fraud

Advantage Medical Transport owner indicted for fraudulent claims


Targeted News Service | | Thursday, May 2, 2013

SCRANTON, Pa. - The United States Attorney's Office for the Middle District of Pennsylvania announced today that a Harrisburg-based ambulance company has pleaded guilty to multiple False Statement charges related to Medicare fraud.

Advantage Medical Transport, Inc, headquartered at 733 Fire House Lane, Harrisburg, pleaded guilty before U.S. District Court Judge Christopher C. Conner today to 14 Counts of False Statements in Health Care Matters, 18 USC 1035. Each Count is punishable by up to as much as a $500,000 fine. Serge Sivchuk, age 27, the sole owner of Advantage, appeared in court and entered the guilty pleas on behalf of the Corporation. The Government estimated the total loss to Medicare as a result of the fraud was approximately $740,000.

According to U.S. Attorney Peter J. Smith, Sivchuk and Advantage were indicted in January 2012 on multiple False Statement and Medicare Fraud charges. The Indictment alleged that between January of 2009 and June of 2011 Sivchuk and Advantage perpetrated a scheme to defraud Medicare by submitting hundreds of claims for the nonemergency transport of Medicare beneficiaries to and from dialysis treatment centers. The Indictment alleged the claims were fraudulent because the patients were ambulatory and the ambulance transports were not medically necessary.

The Indictment focused on an August 2010 audit conducted by Medicare and a June 2, 2011 search of Advantage's business premises by federal law enforcement officers. In response to the audit Sivchuk submitted 14 ambulance Trip Sheets to Medicare that were prepared by Emergency Medical Technicians (EMTs) at the time of each ambulance transport. The Trip Sheets contained a narrative section that described the patient's physical condition and ability to ambulate, and serve as the primary support document for each Medicare billed, ambulance transport claim. The June 2, 2011 search by the FBI and investigators from the Health and Human Services (HHS) Inspector General's Office revealed Sivchuk did not submit the original trip sheets to the auditors but instead submitted copies that had been re-written and forged to conceal the fact the beneficiaries were ambulatory and capable of walking and standing.

During a February 22, 2013 court appearance before Judge Connor, Sivchuk plead guilty to one of the 14 False Statement Counts for which he was indicted, admitting he directed a subordinate to re-write and forge the signatures of two EMTs on a Trip Sheet pertaining to the ambulance transport of a dialysis treatment beneficiary on August 19, 2010. Sivchuk is currently awaiting sentencing and the completion of a pre-sentence report.

Medicare paid Advantage approximately $166 for each leg of a transport to and from a dialysis treatment center, plus $5.49 per mile. Many dialysis patients underwent 3 treatments per week. Thus, one week's transport of just one dialysis patient would yield Advantage more than $1,000.

Under the terms of Advantage's plea agreement Judge Conner will determine the overall loss to Medicare. During the guilty plea proceeding Assistant U.S. Attorney Kim Douglas Daniel told the Court the government intends to show during the loss hearing that the total loss to Medicare was approximately $740,000. Daniel also noted that at the time the investigators executed the June 2, 2011 search warrant, the U.S. Attorney's Office filed a civil action in federal court that froze more than $936,000 in Advantage and Sivchuk controlled bank accounts.

The case is part of a priority program within the U.S. Department of Justice and the U.S. Attorney's Office focusing on Health Care Fraud and a joint investigation by the FBI and the HHS-Office of Inspector General. Anyone with information concerning suspected health care fraud should contact the FBI at 717-232-8686.

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