The Federal Bureau of Investigation (FBI) on January 12, 2012 released the following:
“The United States Attorney’s Office for the Middle District of Pennsylvania announced today that a Harrisburg-based ambulance company, its owner, and a managerial employee have been indicted by a grand jury in Harrisburg on federal health care fraud charges.
Advantage Medical Transport, Inc, headquartered at 733 Fire House Lane, Harrisburg, and its owner, Serge Sivchuk, age 26, also of Harrisburg, were charged in the indictment with 14 counts of health care fraud, one count of conspiracy, and 14 counts of false statements in health care matters. Advantage’s EMT and dispatcher supervisor, David Paul, age 42, of York, Pennsylvania, was also charged with conspiracy and 14 counts of false statements in health care matters.
According to U.S. Attorney Peter J. Smith, the indictment alleges that between January 2009 and June 2011 Advantage and Sivchuk devised and perpetrated a scheme to defraud Medicare out of at least $1,000,000 by submitting hundreds of claims for the non-emergency transport of Medicare beneficiaries to and from dialysis treatment centers. The indictment alleges the claims were fraudulent because the patients were ambulatory and the ambulance transports were not medically necessary.
During 2010 Medicare paid Advantage $166.64 plus $5.49 per mile for each leg of a transport to and from a dialysis treatment center. Many dialysis patients underwent three treatments per week. Thus, one week’s transport of a dialysis patient could yield Advantage more than $1,000.
The indictment focuses on an August 2010 pre-payment audit conducted by Medicare. Allegedly, of 40 claims audited, it was discovered Advantage and Sivchuk had submitted 14 re-written and forged ambulance “Trip Sheets” in support of the claims. The Trip Sheets, which are prepared by Emergency Medical Technicians (EMTs) at the time of each transport, had been allegedly rewritten to omit references to the patients’ ability to walk, stand or otherwise ambulate. The patients’ vital signs (blood pressure, pulse, and respirations) on two Trip sheets were changed and the signatures of some of the EMTs were allegedly forged. The Indictment alleges Sivchuk and Paul directed Advantage’s EMTs to re-write the 14 Trip Sheets and to prepare many others in a manner that concealed the ambulatory nature of the patients.
The indictment alleges the EMTs were threatened with a reduction in hours or termination if they did not prepare the Trip Sheets as they were directed.
Each health care fraud count is punishable by up to 20 years’ imprisonment and $1,000,000 fine. The conspiracy count and each false statement count is punishable by up to five years’ imprisonment and $1,000,000 fine.
The indictment also seeks the criminal forfeiture of Sivchuk’s Farmcrest Lane, Harrisburg, Pennsylvania residence, Advantage’s business premises at 733 Fire House Lane, Harrisburg, $860,972 in six Harrisburg area bank accounts controlled by Sivchuk, plus Sivchuk’s 2006 Bentley and 2010 Land Rover.
The indictment was the result of a federal investigation that began earlier this year with the execution of search warrant at Advantage’s business premises. During the search, voluminous records and documents were seized. At the same time the search warrant was executed, the U.S. Attorney’s Office filed a civil action in U.S. District Court in Harrisburg freezing 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. Anyone with information concerning suspected health care fraud should contact the FBI at 717-232-8686 or HHS at 1-800-HHS-TIPS.
“You have to play by the rules if you want to participate in the Medicare program,” said Nick DiGiulio, Special Agent in Charge of the Inspector General’s Office for the United States Department of Health and Human Services. “We will continue to energetically pursue allegations involving the theft of precious health care dollars.”
The case was investigated by the Harrisburg Offices of the FBI and the U.S. Department of Health & Human Services’ Office of Inspector General. It is being prosecuted by Assistant United States Attorney Kim Douglas Daniel.
An indictment or information is not evidence of guilt but simply a description of the charge made by the grand jury and/or United States Attorney against a defendant. A charged defendant is presumed innocent until a jury returns a unanimous finding that the United States has proven the defendant’s guilt beyond a reasonable doubt or until the defendant has pled guilty to the charges.”
Douglas McNabb – McNabb Associates, P.C.’s
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