Review of Ambulance Services Provided by American Medical Response of Massachusetts, Inc.

EXECUTIVE SUMMARY:

Our objective was to determine whether Medicare payments for ambulance transports and services provided by American Medical Response of Massachusetts, Inc., (AMR) met Medicare reimbursement requirements. For 43 of 100 sampled beneficiaries, medical reviewers determined that AMR received $11,690 in Medicare payments for ambulance transports for the period July 1 through December 1, 2002.

We recommended that AMR develop better controls and work with the Massachusetts carrier to reimburse the Medicare program for the estimated overpayment.  In its response to our draft report, AMR stated that it has adequate controls in place as a result of its compliance program established under its Corporate Integrity Agreement.  AMR agreed with $2,357, or about 20 percent, of our sampled errors.

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