Ambulance Fraud – June 2024 Fraud Fact

Posted:  June 03, 2024

This month’s Fraud Fact from the Missouri SMP (Senior Medicare Patrol) focuses on how to protect yourself from ambulance fraud.

Did you know Medicare covers ambulance services? To be covered it must be medically necessary. The crew and ambulance must meet certain standards. Additionally, it must be the only safe transportation option to the nearest Medicare covered health care center.

It’s important to review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) carefully to detect errors or potential fraud and abuse. If you’ve recently been transported by ambulance look over your MSN over to verify:

• You were not billed more miles than the actual distance of transport.
• You were not billed for emergency transportation if there was no emergency.
• The appropriate service was billed (for example, basic life support vs. advanced life support).

Be aware that Medicare will deny the claim if:

• You could have safely been transported by a wheelchair van or another vehicle.
• You were transported in an unapproved vehicle, like a taxi or OATS bus.
• Your ambulance did not have two emergency medical technicians (EMTs).
• You were taken to a non-covered destination such as your doctor’s office, independent labs, clinics, etc.

If you suspect there may have been errors, fraud or abuse relating to ambulance transportation or any Medicare service, call the Missouri SMP at 1-888-515-6565 or visit Our Website

This project was supported, in part, by the U.S. Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $662,347 with 100 percent funding by ACL/HHS. The contents are those of the author and do not necessarily represent the official views of, nor an endorsement by, ACL/HHS, or the U.S. Government.