N.Y. AG Settles with Ambulance Company

New York Attorney General Andrew Cuomo announced an agreement with a Columbia County ambulance company that was reportedly illegally billing patients for the differences between what the company charged and what the patients’ insurance companies paid.

Under the agreement, the company must pay back at least 29 consumers who were improperly billed over the course of 5 years and change its billing policies to be in accordance with state law.

Hudson-based Greenport Rescue Squad Inc. provides ambulance transportation to hospitals that primarily service the towns of Greenport, Stockport, Claverack, Livingston and the City of Hudson. In June 2007, the Attorney General’s Health Care Bureau commenced an investigation after learning that Greenport improperly billed a consumer for ambulance services.

In that instance, the company submitted a claim to the consumer’s insurer for $797.50 for ambulance services. The insurer provided the usual, customary and reasonable allowance of $448.14 with no deductible or co-payment for the consumer. Greenport then began sending invoices directly to the consumer, requesting payment of $349.36 – the difference of what they billed and the insurer paid.

The invoices stated that non-payment of the bill would result in collections proceedings against the consumer, which would adversely affect his credit rating. The consumer was also incorrectly told by a Greenport representative that he was responsible for the balance of the company’s charges because it did not have a participating provider agreement with the insurer.

The Attorney General’s investigation reportedly found that Greenport Rescue improperly balanced-billed the consumer and had an illegal policy and practice regarding billing. Specifically, the investigation uncovered that between January 2002 through January 2007, 29 patients with comprehensive health care coverage were improperly billed.

Under an agreement with Attorney General Cuomo’s Office, Greenport must establish new procedures for claims review and cease billing patients with comprehensive health care coverage for the difference between the company’s charges and the insurers’ payment.

Additionally, Greenport Rescue must send a letter to every consumer who received ambulance services from Jan. 1, 2002 through July 31, 2008 and then pay restitution if the consumer was balanced billed.