Texas EMS Magazine, Volume 33, Number 6, November/December 2012 Page: 7
40 p. ; col. ill. : 28 cm.View a full description of this periodical.
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patients at dialysis centers, wound
care facilities and so on.
Fraudulent orders you should refuse to
follow
If you are asked to perform or
participate in a fraudulent activity, you
have the right to refuse.'Ihe federal "False
Claims Act" and "Anti-Kickback Statute"
outline activities that are considered
fraudulent and provide protection for
employees to report the fraud.'Ihe
following are examples of activities that
medics should refuse to participate in.
* Your boss has informed you that
you are never to write anything on
a PCR that suggests a patient is
ambulatory.
* You've been called to the office and
told to re-write your PCR narrative
to reflect that a patient was bed-
bound. Or, you have been asked to
add any other language that would
(falsely) establish medical necessity.
* You or someone you know was
threatened, retaliated against or
fired because he or she refused
to falsely alter initial patient
observations on a PCR.
* Your PCRs are written by someone
other than yourself and require only
your signature.
* You and your co-workers are told,
as a matter of company policy,
that you are to write every dialysis
patient's PCR exactly the same way.
* Your company requires that a
12-lead EKG or (TKO) IV be
performed on every patient you
transport-without exception.
* You've been posted at a dialysis
center for the purpose of patient
recruitment regardless of the
prospective patients' physical
conditions.
I'm certain there are many moreexamples, but these come immediately
to mind. If you have credible evidence that
any of the above is happening in your
organization, or if someone has requested
you participate in any of the above, you
have a professional obligation to report
him or her to federal and Texas law
enforcement authorities. Although medics
may fear retaliation or termination for
reporting potential fraud, the federal False
Claims Act does provide whistleblower
protection for those who report.
It's equally important to guard against
false reporting. Wrongly accusing an
ambulance provider of fraudulent business
practices is a serious allegation. It should
not be used as a means to get back at
employers. Hearsay or rumors, such as
"everyone knows they're crooks," do not
constitute credible evidence. If proven,
fraud can lead to lengthy federal prison
sentences and enormous fines, so be sure to
exercise your professional discretion.
I would love to see the nearly 60,000
Texas medics, fully informed about
fraud and actively engaged in rooting
out ambulance fraud in Texas. To report
ambulance fraud using your name or even
anonymously, call or write the Health and
Human Services, Office of the Inspector
General's fraud Hot Line:
Phone: 1-800-HHS-TIPS (1-800-
447-8477)
FAX: 1-800-223-8164
Mail: Office of the Inspector General
Department of Health and Human
Services
ATTN: HOT LINE
P.O. Box 23489
Washington, DC 20026
Bob Kellow is a member of the Texas EMS
Integrity Coalition, which is a group of
concerned Texas ambulance providers who
are dedicated exclusively to the eradication of
ambulance fraud in Texas. He is also a 44-year Texas EMS veteran.
November/December 2012 Texas EMS Magazine 7
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Texas. Department of State Health Services. Texas EMS Magazine, Volume 33, Number 6, November/December 2012, periodical, November 2012; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth541925/m1/7/: accessed July 18, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.