Adventist Health System Sunbelt Healthcare Corp., Winter Park, Fla., will pay $20.3 million to settle allegations that three of its hospitals and an ambulance-services management firm billed government health programs for medically unnecessary ambulance transports. The settlement stems from two civil whistleblower lawsuits filed by former employees of the hospitals or management firm. The management firm, Regional Emergency Services, allegedly conspired with Adventist Sunbelt hospitals in Eustis, Fla., and Killeen and Burleson, Texas, to falsify physician certifications for the medical necessity of ambulance transports from 1993 to 2000 and billed Medicare for the false claims.
Adventist Sunbelt spokesman Kevin Edgerton said the system cooperated in the investigation. "There was never any intent on our part to be unethical or to defraud the government," Edgerton said. "We contracted with an ambulance firm and relied on their expertise. It's evident our oversight was inadequate." At deadline, representatives of Regional Emergency Services could not be reached for comment. Adventist Sunbelt operates 29 hospitals. -- by Mark Taylor