A group of physician-owned emergency-services staffing and billing firms that served Chicago-area hospitals agreed to pay more than $1.1 million to settle civil whistleblower fraud allegations, the U.S. Attorney in Chicago has announced.
The government alleged that EMSCO Billing Services, formerly of Hinsdale, Ill., and National Emergency Services and NES Holdings of Raleigh, N.C., which bought EMSCO and were solely controlled by Allan Rappaport, M.D., falsely billed and upcoded claims submitted to Medicare and Medicaid for emergency services provided at Chicago-area hospitals between 1990 and 1999.
They also overbilled Maine Medicaid, the government alleges.
The defendants agreed to pay the states of Illinois and Maine and the U.S. government, as well as three whistleblowers, but settled without admitting legal guilt and denied wrongdoing, the government said Wednesday.
The government joined the suits in 2001 and 2002.
The suits were filed in U.S. District Court in Chicago in 1996 by whistleblower Linda Trombetta, a former billing supervisor with EMSCO, and later by Linda Freeman, another billing supervisor.
Whistleblower suits against Robert Tetik, M.D., and his ex-wife, who founded and sold the EMSCO billing firm to NES Holdings in 1994, remain pending.
Chicago whistleblower attorney Steven Cohen of the Cohen Law Group said that Illinois' Medicaid program lost millions of dollars as a result of the defendants' fraudulent billing practices. A government audit found the companies had submitted false bills totaling more than $10 million to the Illinois program, Cohen said.
"Unfortunately, by the time the government's investigation was concluded, these same defendants claimed an inability to pay anything close to the real losses the programs incurred," he said.