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ANONYMOUS )
)
Plaintiff, )
)
)
v. ) Case No. ___________________
)
) COMPLAINT FOR VIOLATIONS OF
ANONYMOUS ) THE FALSE CLAIMS ACT, 31 U.S.C.
) §§ 3729, et seq.
)
) FILED UNDER SEAL
Defendant. ) JURY TRIAL DEMANDED
)
2
Case 1:13-cv-01554-RDB Document 12 Filed 07/31/15 Page 3 of 19
INTRODUCTION
1. Qui tam relator Bryan Arvey (“Relator” or “Arvey”), by his attorneys, individually and
on behalf of the United States of America, files this complaint against Hart to Heart
Peninsula Regional Medical Center (PMRC), John Skidmore, Terry Skidmore, and
attorneys’ fees for violations of the federal False Claims Act, 31 U.S.C. §§ 3729 et seq.,
2. John and Terry Skidmore are the owners and operators of both HHTS and EMS and are
services.
7. Medicare Part B covers eighty percent (80%) of a beneficiary’s approved ambulance cost
when “the patient’s condition is such that the use of any other method of transportation is
contraindicated.”
3
Case 1:13-cv-01554-RDB Document 12 Filed 07/31/15 Page 4 of 19
8. Defendant HHTS required Relator Arvey and other ambulance drivers or emergency
medical technicians (EMTs) to falsify their narratives and use inaccurate billing codes to
reflect that ambulance transport was a necessity when such transportation was, in fact,
not a necessity.
9. PRMC staff acquiesced in and facilitated the false narratives by placing patients who
were not bed ridden in their beds on the instruction of HHTS, so that EMT’s could justify
10. Requiring EMTs to falsify their narratives allows HHTS to submit claims to EMS, which
in turn, remits the claims to Medicare for payment that would otherwise need to be
11. In reviewing claims submitted by HHTS, EMS determines which claims are likely to be
accepted by Medicare and which will be rejected. EMS returns to HHTS those claims
that are likely to be rejected by Medicare and identifies the “corrections” necessary to
12. Defendant John Skidmore established and operated HHTS and EMS with the intent to
defraud the United States through the submission of false Medicare claims.
13. Defendant Richard Skidmore is employed as the Vice President of Operations and Safety
to HHTS and explicitly instructed Relator and other HHTS employees to create false
submitted false Medicare claims when they billed Medicare for ambulance transportation
4
Case 1:13-cv-01554-RDB Document 12 Filed 07/31/15 Page 5 of 19
false records in support of those false claims to meet the documentation requirements
defraud the United States by submitting false or fraudulent Medicare claims and by
17. Relator estimates that approximately half of the 50,000 ambulance pick-ups he observed
18. Focusing only on the pick-ups by Relator, himself, could result in the submission of false
19. Relator and other current and former ambulance drivers and EMTs confirm that the
practice of submitting false reports is “very common” and “happens all the time.” Thus,
it is reasonable to assume that drivers other than Relator are forced to submit false
reports.
20. HHTS has been in business for nearly seventeen (19) years and, at present, provides
approximately 69,000 transports per year relying on eighty road units. Depending upon
the prevalence and duration of the falsely submitted claims, the damages to the United
21. To Relator’s knowledge, Defendants’ fraud remains ongoing through to the present.
22. This Court has subject matter jurisdiction over this action under 28 U.S.C. § 1331 and 31
U.S.C. § 3732(a).
5
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23. This Court has personal jurisdiction over Defendants pursuant to 31 U.S.C. § 3732(a)
24. Venue is proper in this Court under 28 U.S.C. §1391(c) and 1395(a), and 31 U.S.C. §
3732(a) because the complained of illegal acts occurred within this judicial district, the
Defendant is a resident of this district, and because the Defendant transacts business
PARTIES
25. Relator Arvey is a thirty (30) year old male and resident of Wicomico County, Maryland.
28. Defendant EMS is a Maryland Corporation, headquartered at the same physical address
transportation companies.
29. Defendant PRMC is a hospital with a full range of medical services, including 292 acute
care beds.
30. Relator made the vast majority of his pick-ups from PRMC.
31. Defendant John Skidmore is the owner, operator, and founder of both HHTS and EMS.
32. Defendant Richard Skidmore is the the Vice President of Operations and Safety at HHTS
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34. At all times material to this complaint, Arvey was employed by Defendant HHTS
35. Arvey has firsthand knowledge of Defendants HHTS’s, EMS’s, and Richard Skidmore’s
FACTUAL ALLEGATIONS
37. Defendant John Skidmore founded HHTS in 1996 to provide ambulance and other
38. HHTS employs more than 350 people and has eighty (80) vehicles in its transportation
fleet.
39. HHTS is licensed to provide emergency medical services, wheelchair services, and sedan
40. HHTS runs approximately 69,000 transports annually and ran 62,000 transports in 2012.
41. HHTS is a licensed provider for Medicare Part B and submits a high volume of Medicare
42. Approximately six years after he founded HHTS, John Skidmore founded Defendant
43. EMS is responsible for processing claims submitted by HHTS and remitting those claims
7
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including wheelchair transports, the cancer bus, and the critical care unit – and assisting
46. For each completed transport, the assigned EMT is responsible for completing a case
report.
47. Completing a case report requires the EMT to identify the appropriate billing code and to
48. Once an EMT completes a case report, that report is submitted to the corporate office.
49. Medical Director Scott Steinmetz, M.D., reviews the case reports and forwards them to
defendant EMS.
50. EMS analyzes the case report and, for cases to be billed to the Centers for Medicare and
Medicaid Services (CMS), ensures that the case report meets all of the requirements for
reimbursement.
51. If the case report meets all necessary requirements, EMS submits the claim to CMS for
payment.
HHTS Directs Relator And Other Employees To Falsify Case Report Narratives
52. If the case report does not meet all of the necessary requirements, EMS returns the case
report to HHTS.
8
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53. Included within its communications to HHTS, EMS identifies the deficiencies that would
prevent the claim from being paid by Medicare under CMS regulations.
54. Defendant Richard Skidmore or, on occasion, Lisa Sievers, Risk & Safety Director, sends
the returned case report to the driver with instructions to make the necessary
“corrections” that will, per CMS regulations, make the claim payable by Medicare.
55. Once the case reports were “corrected,” HHTS re-sent the claims to EMS which would
56. As a result of HHTS forcing its personnel to falsify their reports, the company requires
that its drivers and Emergency Medical Technicians (EMTs) use stretchers to transport
57. For a typical transport, EMTs would arrive at PRMC or other hospitals and instruct the
hospital staff to place the patient in a stretcher, even if the patient did not need one.
58. The EMT would then have the hospital staff transport the patient, who was now on the
59. On one or more occasions, Relator called the HHTS dispatcher to report that a patient
was ambulatory and did not need a stretcher. Dispatch responded by instructing Relator
60. HHTS instructed EMTs that if they saw patients walking, they should leave the room and
ask the hospital staff to put the patient into his or her bed.
61. Once the hospital staff put the patient back in bed, the EMTs and hospital staff would
load the patient onto a stretcher and take them to the ambulance.
9
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62. By forcing its employees to use a stretcher during transportation, HHTS could more
63. If a patient absolutely refused to use the stretcher, Richard Skidmore instructed Relator
and other drivers to falsify their narratives with statements such as “[T]he patient could
not stand, walk or pivot,” or that “[T]he patient could only ambulate with ‘maximum
assistance’ where two HHTS employees were needed to move the patient around.”
64. Such statements made it seem as though transportation by ambulance was a medical
necessity, thereby increasing the chances that the claim would be paid through Medicare.
65. Relator questioned more senior EMTs and paramedics about the practice of falsifying
narratives, but his colleagues told him that he should follow Richard Skidmore’s
66. Richard Skidmore threatened Relator and other employees, stating that a failure to
“correct” their case reports in this manner would result in suspension or termination.
67. Richard Skidmore’s threats were made orally and through e-mail.
68. During a period in or around September 2012 when Relator assisted with office duties,
Relator learned that Richard Skidmore instructed managers to “correct” case reports
themselves by entering an employee’s social security number to access the report within
the system.
10
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69. When HHTS hired Relator in the summer of 2010, the company allowed its drivers to
select from approximately fifty (50) billing codes, some of which indicated that transport
70. Within a few weeks of Relator starting at HHTS, the company eliminated all but two (2)
billing codes.
71. The remaining two billing codes supported claims to Medicare because they indicated
72. Thus, HHTS required Relator and other employees to choose only from billing codes that
defined a particular trip as a medical necessity, even if the trip did not, in fact, meet the
COUNT I
Defendants Knowingly Presented or Caused to be Presented False or Fraudulent Claims
for Payment to the United States in Violation of the False Claims Act
31 U.S.C. § 3729(a)(1)(A)
73. Arvey realleges and incorporates the allegations set forth above as though fully alleged
therein.
74. By virtue of the acts described above, Defendants knowingly presented or caused to be
presented to the United States Government false or fraudulent claims for payment or
3729(a)(1).
75. Medicare Part B covers eighty percent (80%) of a beneficiary’s approved ambulance
11
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77. Defendant HHTS provided transportation via ambulances that was not medically
78. Defendant HHTS caused false claims to be presented to the United States when it
79. When Defendant EMS received a Medicare claim and that did not meet CMS regulations,
it identified the deficiencies in the claim and sent the case report back to HHTS for
“correcting.”
80. HHTS, per instructions from EMS, “corrected” the claims and re-sent the case report and
81. EMS, having already seen the original claims, knew or reasonably should have known
that the “corrected” claims were false when it presented them to CMS for payment.
82. Defendant PRMC acquiesced in and facilitated the medically unnecessary transport of
83. John Skidmore, as founder, owner, and operator of both HHTS and EMS, had knowledge
of and directed the false claim submissions and established the companies with the
84. Terry Skidmore, as owner and operator of HHTS, had knowledge of and directed the
false claim submissions and established the companies with the purpose of engaging in
fraudulent conduct.
12
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85. By reasons of the acts and conduct of the HHTS and EMS in violation of 31 U.S.C. §
3729(a)(1)(A), the United States has suffered actual damages, including the total amounts
paid in response to all such false or fraudulent claims for payment. In addition, the
United States is entitled to recover civil money penalties, and other monetary relief as
deemed appropriate.
COUNT II
Defendants Knowingly Made and Used or Caused to Be Made And Used A False Record
Material To A Fraudulent Claim in Violation of the False Claims Act
31 U.S.C. § 3729(a)(1)(B)
86. Arvey realleges and incorporates the allegations set forth above as though fully alleged
therein.
87. By virtue of the acts described above, Defendants knowingly caused the creation of false
documents and records in support of their false or fraudulent claims for payment or
3729(a)(1)(B).
a. HHTS forced its employees to use billing codes that indicate ambulance service
was a medical necessity when such service, in fact, was not a medical necessity.
b. HHTS forced its employees and PRMC employees to use stretchers when
transporting patients, even when the use of such equipment was not necessary.
HHTS then created false records when it relied on the use of a stretcher as
c. HHTS falsely represented that many of its patients were non-ambulatory and
13
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89. Defendant EMS caused false records to be created by advising HHTS how to “correct”
claims that would not pass the criteria set forth by CMS for payment.
90. John Skidmore, as founder, owner, and operator of both HHTS and EMS, had knowledge
of and directed the creation of false records and established the companies with the
91. Richard Skidmore, as Vice President of Operations and Safety, directed Relator and other
HHTS employees to create false records in support of the company’s fraudulent Medicare
92. By reasons of the acts and conduct of the HHTS and EMS in violation of 31 U.S.C. §
3729(a)(1)(B), the United States has suffered actual damages, including the total amounts
paid in response to all such false or fraudulent claims for payment. In addition, the
United States is entitled to recover civil money penalties, and other monetary relief as
deemed appropriate.
COUNT III
Defendants Conspired To Present False or Fraudulent Claims For Payment to the
United States in Violation of the False Claims Act
31 U.S.C. § 3729(a)(1)(C)
93. Arvey realleges and incorporates the allegations set forth above as though fully alleged
therein.
94. The Federal False Claims Act, 31 U.S.C. § 3729(a)(1)(C) provides for liability against
person who conspires to commit a violation of subparagraph (A), (B), (D), (E), (F), or
(G).”
CONFIDENTIAL AND UNDER SEAL – QUI TAM COMPLAINT
United States ex rel. Arvey v. Hart to Heart Transportation Services, Inc. et. al.
14
Case 1:13-cv-01554-RDB Document 12 Filed 07/31/15 Page 15 of 19
96. John Skidmore is the common owner and founder of both Defendant HHTS and
Defendant EMS.
97. By virtue of the acts described above, Defendants HHTS, PRMC, and EMS entered into a
fraudulent Medicare claims for payment and by making or causing to be made false
services that it knew was non-compliant with CMS regulations for Medicare
its patients by stretcher and ambulance. EMS advised HHTS on how to describe its
services in such a way that would increase the likelihood of payment by the United States
99. By the foregoing acts and omissions, Defendants took action in furtherance of their
conspiracy when HHTS resubmitted “corrected” claims and case reports to EMS, which,
100. Defendants’ were aware of the falsity of the claims and invoices submitted to the
government.
101. Defendants John, Terry, and Richard Skidmore directed HHTS and CMS to
submit false claims and create fraudulent records to support those false claims.
15
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Case 1:13-cv-01554-RDB Document 12 Filed 07/31/15 Page 17 of 19
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JURY DEMAND
Pursuant to Rule 38 of the Federal Rules of Civil Procedure, Bryan Arvey demands a jury trial.
18
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CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing was served via
/s
David L. Scher
19
Case 1:13-cv-01554-RDB Document 12-1 Filed 07/31/15 Page 1 of 19
ANONYMOUS )
)
Plaintiff, )
)
)
v. ) Case No. ___________________
)
) COMPLAINT FOR VIOLATIONS OF
ANONYMOUS ) THE FALSE CLAIMS ACT, 31 U.S.C.
) §§ 3729, et seq.
)
) FILED UNDER SEAL
Defendant. ) JURY TRIAL DEMANDED
)
2
Case 1:13-cv-01554-RDB Document 12-1 Filed 07/31/15 Page 3 of 19
INTRODUCTION
1. Qui tam relator Bryan Arvey (“Relator” or “Arvey”), by his attorneys, individually and
on behalf of the United States of America, files this complaint against Hart to Heart
Peninsula Regional Medical Center (PMRC), John Skidmore, Terry Skidmore, and
attorneys’ fees for violations of the federal False Claims Act, 31 U.S.C. §§ 3729 et seq.,
2. John and Terry Skidmore are the owners and operators of both HHTS and EMS and are
services.
6.7.Medicare Part B covers eighty percent (80%) of a beneficiary’s approved ambulance cost
when “the patient’s condition is such that the use of any other method of transportation is
contraindicated.”
3
Case 1:13-cv-01554-RDB Document 12-1 Filed 07/31/15 Page 4 of 19
8. Defendant HHTS required Relator Arvey and other ambulance drivers or emergency
medical technicians (EMTs) to falsify their narratives and use inaccurate billing codes to
reflect that ambulance transport was a necessity when such transportation was, in fact,
not a necessity.
7.9.PRMC staff acquiesced in and facilitated the false narratives by placing patients who
were not bed ridden in their beds on the instruction of HHTS, so that EMT’s could justify
8.10. Requiring EMTs to falsify their narratives allows HHTS to submit claims to
EMS, which in turn, remits the claims to Medicare for payment that would otherwise
9.11. In reviewing claims submitted by HHTS, EMS determines which claims are likely
to be accepted by Medicare and which will be rejected. EMS returns to HHTS those
claims that are likely to be rejected by Medicare and identifies the “corrections”
10.12. Defendant John Skidmore established and operated HHTS and EMS with the
intent to defraud the United States through the submission of false Medicare claims.
11.13. Defendant Richard Skidmore is employed as the Vice President of Operations and
Safety to HHTS and explicitly instructed Relator and other HHTS employees to create
submitted false Medicare claims when they billed Medicare for ambulance transportation
4
Case 1:13-cv-01554-RDB Document 12-1 Filed 07/31/15 Page 5 of 19
creation of false records in support of those false claims to meet the documentation
to defraud the United States by submitting false or fraudulent Medicare claims and by
15.17. Relator estimates that approximately half of the 50,000 ambulance pick-ups he
observed during his time employed by defendants were not medically necessary.
16.18. Focusing only on the pick-ups by Relator, himself, could result in the submission
17.19. Relator and other current and former ambulance drivers and EMTs confirm that
the practice of submitting false reports is “very common” and “happens all the time.”
Thus, it is reasonable to assume that drivers other than Relator are forced to submit false
reports.
18.20. HHTS has been in business for nearly seventeen (179) years and, at present,
provides approximately 69,000 transports per year relying on eighty road units.
Depending upon the prevalence and duration of the falsely submitted claims, the damages
present.
5
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20.22. This Court has subject matter jurisdiction over this action under 28 U.S.C. § 1331
21.23. This Court has personal jurisdiction over Defendants pursuant to 31 U.S.C. §
22.24. Venue is proper in this Court under 28 U.S.C. §1391(c) and 1395(a), and 31
U.S.C. § 3732(a) because the complained of illegal acts occurred within this judicial
district, the Defendant is a resident of this district, and because the Defendant transacts
PARTIES
23.25. Relator Arvey is a thirty (30) year old male and resident of Wicomico County,
Maryland.
address as Defendant HHTS. EMS is in the business of claims processing for medical
transportation companies.
29. Defendant PRMC is a hospital with a full range of medical services, including 292 acute
care beds.
27.30. Relator made the vast majority of his pick-ups from PRMC.
6
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28.31. Defendant John Skidmore is the owner, operator, and founder of both HHTS and
EMS.
29.32. Defendant Richard Skidmore is the the Vice President of Operations and Safety at
31.34. At all times material to this complaint, Arvey was employed by Defendant HHTS
32.35. Arvey has firsthand knowledge of Defendants HHTS’s, EMS’s, and Richard
FACTUAL ALLEGATIONS
34.37. Defendant John Skidmore founded HHTS in 1996 to provide ambulance and
35.38. HHTS employs more than 350 people and has eighty (80) vehicles in its
transportation fleet.
37.40. HHTS runs approximately 69,000 transports annually and ran 62,000 transports in
2012. Defendant’s Salisbury, Maryland location, out of which Relator worked, runs
7
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38.41. HHTS is a licensed provider for Medicare Part B and submits a high volume of
39.42. Approximately six years after he founded HHTS, John Skidmore founded
40.43. EMS is responsible for processing claims submitted by HHTS and remitting those
claims to the United States for payment through the Medicare program.
– including wheelchair transports, the cancer bus, and the critical care unit – and assisting
43.46. For each completed transport, the assigned EMT is responsible for completing a
case report.
44.47. Completing a case report requires the EMT to identify the appropriate billing code
45.48. Once an EMT completes a case report, that report is submitted to the corporate
office.
46.49. Medical Director Scott Steinmetz, M.D., reviews the case reports and forwards
8
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47.50. EMS analyzes the case report and, for cases to be billed to the Centers for
Medicare and Medicaid Services (CMS), ensures that the case report meets all of the
48.51. If the case report meets all necessary requirements, EMS submits the claim to
HHTS Directs Relator And Other Employees To Falsify Case Report Narratives
49.52. If the case report does not meet all of the necessary requirements, EMS returns
50.53. Included within its communications to HHTS, EMS identifies the deficiencies
that would prevent the claim from being paid by Medicare under CMS regulations.
51.54. Defendant Richard Skidmore or, on occasion, Lisa Sievers, Risk & Safety
Director, sends the returned case report to the driver with instructions to make the
necessary “corrections” that will, per CMS regulations, make the claim payable by
Medicare.
52.55. Once the case reports were “corrected,” HHTS re-sent the claims to EMS which
would then remit the revised claims for payment through Medicare.
56. As a result of HHTS forcing its personnel to falsify their reports, the company requires
that its drivers and Emergency Medical Technicians (EMTs) use stretchers to transport
57. For a typical transport, EMTs would arrive at PRMC or other hospitals and instruct the
hospital staff to place the patient in a stretcher, even if the patient did not need one.
9
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53.58. The EMT would then have the hospital staff transport the patient, who was now
59. On one or more occasions, Relator called the HHTS dispatcher to report that a patient
was ambulatory and did not need a stretcher. Dispatch responded by instructing Relator
60. HHTS instructed EMTs that if they saw patients walking, they should leave the room and
ask the hospital staff to put the patient into his or her bed.
54.61. Once the hospital staff put the patient back in bed, the EMTs and hospital staff
would load the patient onto a stretcher and take them to the ambulance.
55.62. By forcing its employees to use a stretcher during transportation, HHTS could
56.63. If a patient absolutely refused to use the stretcher, Richard Skidmore instructed
Relator and other drivers to falsify their narratives with statements such as “[T]he patient
could not stand, walk or pivot,” or that “[T]he patient could only ambulate with
‘maximum assistance’ where two HHTS employees were needed to move the patient
around.”
medical necessity, thereby increasing the chances that the claim would be paid through
Medicare.
10
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58.65. Relator questioned more senior EMTs and paramedics about the practice of
falsifying narratives, but his colleagues told him that he should follow Richard
59.66. Richard Skidmore threatened Relator and other employees, stating that a failure to
“correct” their case reports in this manner would result in suspension or termination.
60.67. Richard Skidmore’s threats were made orally and through e-mail.
61.68. During a period in or around September 2012 when Relator assisted with office
duties, Relator learned that Richard Skidmore instructed managers to “correct” case
reports themselves by entering an employee’s social security number to access the report
62.69. When HHTS hired Relator in the summer of 2010, the company allowed its
drivers to select from approximately fifty (50) billing codes, some of which indicated that
63.70. Within a few weeks of Relator starting at HHTS, the company eliminated all but
64.71. The remaining two billing codes supported claims to Medicare because they
65.72. Thus, HHTS required Relator and other employees to choose only from billing
codes that defined a particular trip as a medical necessity, even if the trip did not, in fact,
COUNT I
Defendants Knowingly Presented or Caused to be Presented False or Fraudulent Claims
CONFIDENTIAL AND UNDER SEAL – QUI TAM COMPLAINT
United States ex rel. Arvey v. Hart to Heart Transportation Services, Inc. et. al.
11
Case 1:13-cv-01554-RDB Document 12-1 Filed 07/31/15 Page 12 of 19
for Payment to the United States in Violation of the False Claims Act
31 U.S.C. § 3729(a)(1)(A)
66.73. Arvey realleges and incorporates the allegations set forth above as though fully
alleged therein.
67.74. By virtue of the acts described above, Defendants knowingly presented or caused
to be presented to the United States Government false or fraudulent claims for payment
3729(a)(1).
necessary. Medical necessity exists in cases where no means of transportation other than
70.77. Defendant HHTS provided transportation via ambulances that was not medically
71.78. Defendant HHTS caused false claims to be presented to the United States when it
72.79. When Defendant EMS received a Medicare claim and that did not meet CMS
regulations, it identified the deficiencies in the claim and sent the case report back to
73.80. HHTS, per instructions from EMS, “corrected” the claims and re-sent the case
report and false claims to EMS for processing and remittance to the government.
12
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81. EMS, having already seen the original claims, knew or reasonably should have known
that the “corrected” claims were false when it presented them to CMS for payment.
75.83. John Skidmore, as founder, owner, and operator of both HHTS and EMS, had
knowledge of and directed the false claim submissions and established the companies
76.84. Terry Skidmore, as owner and operator of HHTS, had knowledge of and directed
the false claim submissions and established the companies with the purpose of engaging
in fraudulent conduct.
77.85. By reasons of the acts and conduct of the HHTS and EMS in violation of 31
U.S.C. § 3729(a)(1)(A), the United States has suffered actual damages, including the total
amounts paid in response to all such false or fraudulent claims for payment. In addition,
the United States is entitled to recover civil money penalties, and other monetary relief as
deemed appropriate.
COUNT II
Defendants Knowingly Made and Used or Caused to Be Made And Used A False Record
Material To A Fraudulent Claim in Violation of the False Claims Act
31 U.S.C. § 3729(a)(1)(B)
78.86. Arvey realleges and incorporates the allegations set forth above as though fully
alleged therein.
79.87. By virtue of the acts described above, Defendants knowingly caused the creation
of false documents and records in support of their false or fraudulent claims for payment
13
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3729(a)(1)(B).
a. HHTS forced its employees to use billing codes that indicate ambulance service
was a medical necessity when such service, in fact, was not a medical necessity.
b. HHTS forced its employees and PRMC employees to use stretchers when
transporting patients, even when the use of such equipment was not necessary.
HHTS then created false records when it relied on the use of a stretcher as
c. HHTS falsely represented that many of its patients were non-ambulatory and
81.89. Defendant EMS caused false records to be created by advising HHTS how to
“correct” claims that would not pass the criteria set forth by CMS for payment.
82.90. John Skidmore, as founder, owner, and operator of both HHTS and EMS, had
knowledge of and directed the creation of false records and established the companies
83.91. Richard Skidmore, as Vice President of Operations and Safety, directed Relator
and other HHTS employees to create false records in support of the company’s fraudulent
14
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84.92. By reasons of the acts and conduct of the HHTS and EMS in violation of 31
U.S.C. § 3729(a)(1)(B), the United States has suffered actual damages, including the total
amounts paid in response to all such false or fraudulent claims for payment. In addition,
the United States is entitled to recover civil money penalties, and other monetary relief as
deemed appropriate.
COUNT III
Defendants Conspired To Present False or Fraudulent Claims For Payment to the
United States in Violation of the False Claims Act
31 U.S.C. § 3729(a)(1)(C)
85.93. Arvey realleges and incorporates the allegations set forth above as though fully
alleged therein.
86.94. The Federal False Claims Act, 31 U.S.C. § 3729(a)(1)(C) provides for liability
against person who conspires to commit a violation of subparagraph (A), (B), (D), (E),
(F), or (G).”
88.96. John Skidmore is the common owner and founder of both Defendant HHTS and
Defendant EMS.
89.97. By virtue of the acts described above, Defendants HHTS, PRMC, and EMS
presented false or fraudulent Medicare claims for payment and by making or causing to
services that it knew was non-compliant with CMS regulations for Medicare
CONFIDENTIAL AND UNDER SEAL – QUI TAM COMPLAINT
United States ex rel. Arvey v. Hart to Heart Transportation Services, Inc. et. al.
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its patients by stretcher and ambulance. EMS advised HHTS on how to describe its
services in such a way that would increase the likelihood of payment by the United States
91.99. By the foregoing acts and omissions, Defendants took action in furtherance of
their conspiracy when HHTS resubmitted “corrected” claims and case reports to EMS,
92.100. Defendants’ were aware of the falsity of the claims and invoices submitted to the
government.
93.101. Defendants John, Terry, and Richard Skidmore directed HHTS and CMS to
submit false claims and create fraudulent records to support those false claims.
United States has suffered substantial losses, and is entitled to treble damages under the
False Claims Act, to be determined at trial, plus a civil penalty of $5,500 to $11,000 for
WHEREFORE, the Relator Bryan Arvey, acting on behalf of and in the name of the United
States of America, and on her own behalf, prays that judgment be entered against Defendants for
(a) In favor of the United States against the Defendants for treble damages to the federal
government from the submission of false claims, and the maximum civil penalties for
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(b) In favor of the Relator for the maximum amount pursuant to 31 U.S.C. § 3730(d) to
include reasonable expenses, attorney fees, and costs incurred by the Relator;
(c) For all costs of the False Claims Act civil action; and
(d) In favor of the Relator and the United States for further relief as this court deems just and
equitable.
Respectfully submitted,
_____________________________
R. Scott Oswald, DMD Bar No. 25391
David L. Scher, DMD Bar No. 17187
The Employment Law Group, P.C.
888 17th Street, N.W., Suite 900
Washington, D.C. 20006
(202) 261 – 2810
(202) 261 – 2835 (facsimile)
soswald@employmentlawgroup.com
dscher@employmentlawgroup.com
Counsel for Plaintiff-Relator
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JURY DEMAND
Pursuant to Rule 38 of the Federal Rules of Civil Procedure, Bryan Arvey demands a jury trial.
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CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the foregoing was served via
/s
David L. Scher
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