President Of Ambulance Company Pleads Guilty To Perjury In Connection With False Health Care Claims Investigation

RALEIGH - United States Attorney Thomas G. Walker announced that today in federal court, JAIME LEONARD SMITH, 35, of Morehead City, North Carolina, pleaded guilty to Perjury.

According to the Criminal Information, SMITH was the president of CCMT, Inc., doing business as Crystal Coast Medical Transport (CCMT).  CCMT was a nonemergency ambulance transportation company that operated in Craven and Carteret counties.

In 2012, CCMT and SMITH became the subject of investigation after a member of the public videotaped CCMT employees routinely transporting patients in CCMT ambulances when the patients had the ability to walk or ride in wheelchairs.  Medicare and TRICARE generally do not cover nonemergency ambulance transportation services when the patient has the ability to walk or ride in a wheelchair.  Additionally, for reimbursement to be covered by Medicare and TRICARE, the ambulance company must obtain an order, known as a Physician’s Certification Statement (PCS), from the patient’s physician indicating that the ambulance trip is medically required.

In October of 2013, the United State Attorney’s Office for the Eastern District of North Carolina (USAO-EDNC) issued Civil Investigative Demand (CID) upon CCMT, to the attention of SMITH.  The CID required CCMT to produce to the government, “Any and all Physician Certification Statements on which you relied to provide ambulance transport to any beneficiary of a government healthcare program, including but not limited to Medicare, Medicaid, or TRICARE for the time period January 1, 2011 [to] the present.”  In November of 2013, SMITH produced records and swore under oath that the records she produced were responsive to the CID.

In fact, the investigation revealed that in many instances, SMITH had altered the PCS forms to include additional markings that were not made by the patients’ physicians.  In some instances, PCS forms were fabricated to cover dates of service for which no genuine PCS form existed.  In other instances, the PCS forms were altered to include additional markings that were not made by the patient’s physician.  For example, some PCS forms were altered to indicate that the ambulance transport was medically necessary, or to reflect that the patient had additional illnesses or medical conditions justifying the ambulance transport.

In no instance did the physicians authorize SMITH or any other agent of CCMT to fabricate or alter PCS forms for their patients.

At sentencing, SMITH faces up to 5 years in prison and 3 years of supervise release.  The defendant also faces a fine of up to $250,000 and restitution if ordered by the court.

The investigation of this case was conducted by agents of the United States Department of Health and Human Services Office of the Inspector General, and the Defense Criminal Investigative Service.  Assistant United States Attorney William M. Gilmore of the Economic Crimes Division represents the United States.