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East Texas Ambulance Operator Guilty Of Health Care Fraud

A 62-year-old Longview, Texas man has pleaded guilty to federal violations in the Eastern District of Texas, announced U.S. Attorney Joseph D. Brown. Joseph Valdie Kimble pleaded guilty to health care fraud on Sep. 11, 2019, before U.S. Magistrate Judge John D. Love.

Kimble’s plea was announced today during a press conference held in Dallas with Texas U.S. Attorneys and the Assistant Attorney General of the Justice Department’s Criminal Division. A total of 58 individuals across all four federal districts in Texas were charged for their alleged involvement in Medicare fraud schemes and networks of “pill mill” clinics resulting in $66 million in loss and 6.2 million pills. Of those charged, 16 were doctors or medical professionals, and 20 were charged for their role in diverting opioids.

According to information presented in court, Kimble operated Tiger EMS, a business providing non-emergency ambulance transport, mostly between skilled nursing centers and hospitals and dialysis centers. Ambulance providers may bill for ambulance services only if there is a demonstrated medical need, which requires that either a beneficiary be bed-confined and it is documented that other methods of transportation are contraindicated; or the beneficiary’s medical condition is such that transportation by ambulance is medically required. Kimble disregarded medical necessity requirements and billed Medicare and Medicaid for ambulance services provided to patients for whom ambulance transport was not medically necessary. The plea agreement provides for an agreed sentence of 30 months in federal prison and $751,986.80 in restitution.

“Every dollar stolen from Medicare through fraud comes out of the pocket of taxpayers,” said U.S. Attorney Joseph D. Brown of the Eastern District of Texas. “These are real costs that help drive up the cost of medical services for everyone. It is important that there be real consequences for those who cheat the system.” A sentencing hearing will be scheduled at a later date.

This case was investigated by U.S. Health and Human Services, Office of Inspector General, and the Texas Attorney General’s Medicaid Fraud Control Unit and is being prosecuted by Assistant U.S. Attorney Alan R. Jackson.