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Press Release

Press Release  AG Campbell Reaches $1.6M Settlement with North Dartmouth Ambulance Companies to Resolve False Billing Allegations

For immediate release:
2/06/2024
  • Office of the Attorney General

Media Contact   for AG Campbell Reaches $1.6M Settlement with North Dartmouth Ambulance Companies to Resolve False Billing Allegations

Sabrina Zafar , Deputy Press Secretary

BostonAttorney General Andrea Joy Campbell and her office have reached a $1.6 million settlement with affiliated transportation providers STAT Ambulance Services, Inc. and Southcoast Emergency Medical Services, Inc., along with their owner Carol Mansfield, to resolve allegations that the companies submitted false claims to MassHealth, the state’s Medicaid program, and that Southcoast submitted false claims to the Medicare program. 

“When providers fail to comply with MassHealth regulations, the program suffers,” said AG Campbell. “I’m proud of my team’s efforts in securing this settlement, which will protect the integrity of the MassHealth program so it can continue to provide crucial health care support for our most vulnerable residents.”  

STAT Ambulance Service, Inc. and Southcoast Emergency Medical Services, Inc. are transportation and ambulance companies headquartered in North Dartmouth and owned by Carol Mansfield of Mattapoisett. Both companies are MassHealth transportation providers.   

The AG’s Office contends that since at least January 2015, both companies regularly falsified and “upcoded” their claims to MassHealth by purposefully miscoding their rendered services to file more expensive claims. For example, the companies billed for emergency services when only nonemergency services were provided and billed for advanced ambulance services when only basic ambulance services were provided.

The Attorney General’s Office further alleges that both companies billed MassHealth for medically unnecessary services, instructing employees to falsify service documentation to support “upcoded” claims to MassHealth, and to have routinely failed to comply with MassHealth’s requirements regarding medical necessity forms for nonemergency transportation services. In addition, Southcoast is alleged to have billed Medicare for medically unnecessary services and to have failed to comply with federal requirements regarding medical necessity documentation for nonemergency transportation services. 

Under the terms of the settlement, in addition to paying back $1.6 million to MassHealth and Medicare, STAT and Southcoast have agreed to retain an independent compliance monitor and to implement company-wide training and auditing to ensure future compliance with all state and federal laws and regulations.   

This settlement is part of AG Campbell’s ongoing efforts to combat fraud committed by ambulance providers. In August 2023, AG Campbell announced a $2.6 million settlement with MedStar Ambulance, Inc. to resolve allegations that they knowingly submitted claims for a higher level of service than they provided and failed to comply with MassHealth medical necessity requirements. 

This matter was handled by Assistant Attorney General Kevin O’Keefe, Senior Trial Counsel Elisha Willis, Assistant Attorney General Mary-Ellen Kennedy, Investigations Supervisor Dean Bates, and Senior Healthcare Fraud Investigator William Welsh, all of AG Campbell’s Medicaid Fraud Division. MassHealth and the Boston Regional Office of the Office of Inspector General of the U.S. Department of Health and Human Services provided substantial assistance with this investigation. 

The Massachusetts Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,865,996 for federal fiscal year 2024. The remaining 25 percent, totaling $1,955,330 for FY 2024, is funded by the Commonwealth of Massachusetts. 

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Media Contact   for AG Campbell Reaches $1.6M Settlement with North Dartmouth Ambulance Companies to Resolve False Billing Allegations

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