| Medlocks indicted for Medicaid fraud |
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By: Lisa Marchesoni
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Posted: Tuesday, January 12, 2010 2:26 pm
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Owners of Murfreesboro Ambulance Service were charged Tuesday in a 35-count indictment accusing them of conspiring to charge Medicare and Medicaid with $434,910.14 in fraud charges for service of five ambulatory patients, the U.S. Attorney’s office reported.
Woody Medlock, Sr., 66, his wife, Kathy Medlock, 54, and son, Woody Medlock, Jr., of state Route 96 East (New Lascassas Highway), were arrested on charges of conspiracy, Medicare fraud and wire fraud.
The indictment was returned Wednesday, Jan. 6 by a federal grand jury in Nashville, the U.S. Attorney’s office reported in a press release.
The Medlocks are the owners and operators of the Murfreesboro Ambulance Service. Woody Medlock, Jr., 44, is a supervisor for the ambulance service.
They are scheduled for initial appearances Tuesday afternoon before Magistrate Judge John S. Bryant.
The indictment represents the culmination of a joint federal and state investigation into alleged fraudulent billing practices of Murfreesboro Ambulance Service to Medicare and Medicaid for transportation of dialysis patients.
The 35-count indictment alleges that from some time in 1996 through September 2008, the Medlocks conspired and engaged in a scheme to defraud Medicare and Medicaid by submitting claims for payment for the transportation of patients who were not qualified to receive ambulance transportation.
The indictment alleges that the Medlocks submitted or caused to be submitted, through Murfreesboro Ambulance Service, fraudulent claims to Medicare and Medicaid for reimbursement of ambulance transports of beneficiaries to and from dialysis totaling at least $1 million and resulting in payments from Medicare of at least $ $486,813.83, and from Medicaid of at least $101,000.
Special Agent Chris Covington of the U.S. Department of Health and Human Services and Special Agent Matthew Stephenson of the U.S. Secret Service accused the Medlocks
of billing the federal Medicare and Medicaid insurance program for patients who didn’t require an ambulance for transport to dialysis appointment.
Medicare is a federal insurance program for citizens ages 65 and older and others with disabilities.
“MAS was in effect acting as a taxi, charging the government in excess of $300 round trip to transport an ambulatory person to a dialysis appointment,” Covington reported. “In some cases, even though the paperwork appeared to support ambulance transport for a patient, MAS did not staff the ambulance with appropriate personnel to care for the patient and MAS allowed the patient to ride in the front of the ambulance rather than on a stretcher.”
Covington did surveillance and found the patients walked to the ambulance and often rode in the front seat.
Stephenson accused the Medlocks of transferring funds from the business account to their personal account to purchase a $66,000 Chevrolet Corvette and a 2008 Harley Davidson Heritage motorcycle. Agents seized from them the Corvette, motorcycle, $110,611.92 in one account and $3,620.20 from a second account at Pinnacle National Bank in August during a search of their home/office.
Both the Medlocks are fighting to get the property returned and Pinnacle is seeking to recoup its loss as the lien holder of the Corvette.
In his investigation, Covington reported Medicare requires ambulances to be staffed by two people and one must be a certified emergency medical technician and authorized to perform lifesaving measures. Also, Medicare patients transported by an ambulance must be medically necessary such as the patient being bedridden, can’t walk or sit in a chair or wheelchair.
Also, if two patients share an ambulance, Medicare will not pay the full amount for each patient.
In his investigation, Stephenson learned Murfreesboro Ambulance Service was owned by Medlock, his wife, Kathy, is the billing manager, and his son, Woody “Bubba” Medlock Jr. is the assistant director. In September 2008, Murfreesboro Ambulance provided eight ambulance and more than 30 full and parttime employees.
Murfreesboro Ambulance Service was selected for a Medicare audit because it was the fifth highest paid ambulance provider in 2005 among 82 state ambulance providers transporting patients to and from dialysis clinics, In 2005, dialysis transports accounted for 74 percent of Medicare payments to Murfreesboro Ambulance Service.
If convicted, the Medlocks face up to 20 years in prison and a $250,000 fine. Any sentence following conviction will be imposed by the court after consideration of the U.S. Sentencing Guidelines and applicable federal statutes.
The United States Department of Health and Human Services, Office of Inspector General, the Memphis Field Office of the Federal Bureau of Investigation and the Tennessee Bureau of Investigation are investigating this case. The United States is represented by Assistant United States Attorneys John K. Webb and Sandra G. Moses.
An indictment is merely an allegation and is not evidence of guilt.
A charged defendant is presumed innocent and is entitled to a jury trial at which the Government would bear the burden of proof beyond a reasonable doubt as to each count of the information.
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