On the day they were to go to trial in Lexington, managers of a Breathitt County ambulance service pleaded guilty to federal charges that they defrauded taxpayer-funded health plans by submitting false bills.
Arrow-Med Ambulance owner Hershel Jay Arrowood, his wife, Lesa Arrowood, and manager Terry Herald pleaded guilty Tuesday to two counts of aiding and abetting each other to submit false health bills from September 2012 to August 2015. Thirteen other counts will be dismissed at sentencing.
As part of their plea agreements, the Arrowoods and Arrow-Med Ambulance agree to a judgment of $249,539, which represents the proceeds the company obtained from the fraud.
Medicare will pay for non-emergency ambulance runs but only in cases that are medically necessary.
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The defendants “knowingly and voluntarily billed Medicare and Medicaid for non-emergency ambulance transports” for patients whom they knew did not qualify because their medical conditions were such that they could safely travel by some other from of transportation, according to court records.
As a result, Medicaid paid Arrow-Med Ambulance $18,961 for medically unnecessary transports of one patient identified only as “J.B.,” and Medicare paid $230,588 for medically unnecessary transports of patients identified only as “J.B.” and “C.H.”
One patient was a woman whom Arrow-Med took for dialysis even though she could walk and didn’t need to go by ambulance.
In another case, a patient refused to get in the back of the ambulance and rode up front to the dialysis clinic.
Court records didn’t indicate when U.S. District Judge Joseph M. Hood scheduled sentencing.
The charges in the criminal case carry a top sentence of 10 years in prison.