A recent federal audit has uncovered that in the first six months of 2012, $30 million was billed to Medicare for some ambulance transports later termed “mystery rides” because agents could not determine whether the patient had actually received any medical care after the purported ambulance ride.
“[They’re] mystery rides because we don’t have any information in our files, in Medicare files, to show what medical service the person received, of if they received a medical service,” said Suzanne Murrin, deputy inspector general at the U.S. Department of Health and Human Services. “Certainly, Medicare was not billed for a medical service, either on the way, where the person left or where the person arrived at.”
The audit, conducted by HHS’ inspector general’s office, dug into Medicare claims for 7.3 million ambulance transports from the first six months of 2012. Medicare pays for ambulance rides for patients to see their doctors, if there is a medical need like the patient cannot walk.
The audit found that $24 million also had been paid out by Medicare “for ambulance transports that did not meet certain program requirements to justify payment.”
“I think what we are finding is that there is a great deal of questionable billing, and there is a great deal,” Murrin said. “This is still a program that needs further action to address weaknesses.”
Philadelphia and Houston are trouble spots but investigators say Los Angeles and New York should be added to the list.
The Centers for Medicaid and Medicare Services told ABC News recently that it was “strongly committed to eliminating fraud, waste and abuse in ambulance transports” and had put several initiatives in place to fight the problem since 2012.