Wells EMS reaches $340K settlement over allegations of Medicare fraud
Wells EMS Settles Medicare Fraud Allegations for $340,000
Wells, Maine – The town’s ambulance provider, Wells Emergency Medical Services (EMS), has reached a $339,972 settlement with the federal government and a former employee who accused the company of Medicare fraud. The payment resolves claims that the agency improperly billed for non‑emergency patient transfers over a decade, sparing it from a potentially costly trial.
The allegations, first brought forward by a former Wells EMS employee, allege that between January 2010 and September 2020 the company up‑coded roughly 150 inter‑facility transfers per year as emergencies. The resulting overbilling was estimated at $267,996 to the U.S. Centers for Medicare & Medicaid Services. The whistleblower sued on behalf of the federal government, seeking damages and legal fees.
In a brief special meeting of the Wells Board of Selectmen held on Tuesday, board president Brian Toomey and the company’s attorney, Robert Hayes, confirmed the settlement. The same day court documents in the case were unsealed, making the details public.
“We’re not admitting guilt,” Hayes said, “but this is a compromise to avoid the lengthy trial that could have taken months. The government could have sought triple the amount of alleged overbilling in damages. This settlement is a pragmatic way to resolve the matter and put the matter to rest.”
The payment covers both damages and legal fees. Insurance will contribute $50,000 toward the total. Once the deal is finalized, the whistleblower’s lawsuit will be dismissed, Hayes explained. Toomey underscored that no one on the current board was involved in the alleged fraud, citing a turnover of board members over the years.
“This was the best course of action for WEMS,” Hayes added. “The current WEMS board has been momentous in getting this to a place where we can resolve it and instituting actions that ensure that it wasn’t ongoing and wouldn’t happen in the future.”
Wells EMS has denied wrongdoing. The company’s settlement does not constitute an admission of fault; it simply releases the agency from liability for the alleged overbilling. The settlement amount is smaller than the potential damages the federal government could have pursued, reflecting a negotiated resolution rather than a court determination.
The case was one of several recent investigations into ambulance providers across New England for improper billing practices. The federal government has been tightening its scrutiny of non‑emergency inter‑facility transfers, a move that has prompted several providers to reassess billing protocols.
For the residents of Wells, the settlement means the town’s ambulance service can refocus on its core mission without the burden of a prolonged legal battle. The town’s Selectmen and the EMS board have pledged to implement new oversight measures to prevent future billing errors and to ensure compliance with federal regulations.
The settlement was announced at the same time court documents were made public, giving the community a clear view of the facts. The case is now closed, and the lawsuit filed by the whistleblower has been dismissed.
