ADVENTIST HEALTH SYSTEM, HOSPITALS, AMBULANCE COMPANIES
TO PAY U.S. MORE THAN $20 MILLION TO SETTLE FRAUD CLAIMS

WASHINGTON, D.C. - Winter Park, Florida-based Adventist Health System Sunbelt Healthcare Corporation, three affiliated hospitals and a management company that administered ambulance operations at the three hospitals have agreed to pay the U.S. $20.3 million to settle allegations that they overcharged Medicare, the Justice Department and the Department of Health and Human Services announced today. The government alleged that the charged were for ambulance transports for patients which were not medically necessary.

The government further alleged that Regional Emergency Services and the hospitals created false physician certifications regarding the medical necessity of ambulance transports operated by the hospitals and submitted or caused to be submitted claims to Medicare. The suit alleges that the false claims were submitted during 1993 through 2000 in the case of Florida Hospital Waterman and Metroplex Adventist Hospital, and 1993 through 1997 in the case of Huguley Memorial Medical Center.

"This settlement again demonstrates the United States’ commitment to protecting federal funds from fraud and abuse," said Peter D. Keisler, Assistant Attorney General in charge of the Civil Division.

The settlement resolves claims brought under the qui tam or whistleblower provisions of the False Claims Act in United States ex rel. Mulligan v. Florida Hospital Waterman, Inc., and Florida Regional Emergency Medical Services (M.D. Fla.), and will also cover certain allegations by a relator in United States ex rel. Wightman v. Laidlaw, Inc., et al. (W.D. Tex.). Under the False Claims Act, private individuals who bring suits against companies can receive between 15 and 25 percent of the recovery in a case in which the government intervenes.

Kevin Mulligan, who was employed by Florida Hospital Waterman as an emergency medical technician, will receive approximately $1.9 million dollars as his part of the settlement. Adam Wightman will be awarded approximately half a million dollars.

The case was conducted by the Civil Division of the Department of Justice.

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