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United Medical Response and Derrick Isham Agreed to Be Excluded for 5 Years for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services Covered by the SNF Consolidated Billing Payment

On October 16, 2023, United Medical Response, Inc. (United) and Derrick Isham (Isham), Winston, Georgia, agreed to be excluded from participation in all Federal health care programs for 5 years under 42 U.S.C. 1320a-7(b)(7). Based on the investigation, OIG alleged that United and Isham presented claims to Medicare Part B for ambulance transportation services to and from skilled nursing facilities (SNFs) where such transportation was already covered by the SNF consolidated billing payment under Medicare Part A. OIG's Office of Audit Services and Office of Counsel to the Inspector General, represented by Senior Counsels Srishti Sheffner and Andrea Treese Berlin with the assistance of Chief Investigator Amber Mahmood and Paralegal Specialist Jennifer Hilton, collaborated to achieve this resolution.

Action Details

  • Date:October 16, 2023
  • Enforcement Types:
    • CMP and Affirmative Exclusions