Whistleblower Prompts Rural/Metro Ambulance to Pay $5.4 Million Qui Tam Settlement

Shortly into his job as an EMT at ambulance giant Rural/Metro Corp, Carl Crawley began to notice things that made him uneasy. In September 2009, he blew the whistle, filing a Medicare fraud qui tam complaint under seal in federal court in Alabama, styled U.S. ex rel. Crawley v.Rural/Metro, 2:09-cv-01810-RDP.

Now, more than two years later, the company has agreed to pay $5,426,000; Crawley and his legal team will be awarded $1,030,940 plus statutory fees and costs.

According to court documents, Crawley “witnessed on a daily basis Rural/Metro’s regular practice of falsifying Medicare-required documents” and “billing Medicare and Medicaid for ambulance services that were never provided and were medically unnecessary.” After the complaint went public, Crawley’s attorneys say he had difficulty getting a new job as an EMT. To support his family, he took work anywhere he could find it, eventually as a night watchman — and he went back to college to pursue a criminal justice degree.

Former Rural/Metro EMT Carl Crawley was “uneasy” over practices he witnessed at his former employer.

“Carl Crawley was willing to jeopardize his career to safeguard the American healthcare system and the taxpayers’ trust,” says Henry Frohsin, one of three attorneys who represented Crawley. “It’s an honor and a pleasure to serve as his counsel. Frankly, I’m proud to know him. This country needs more heroes like Carl who are willing to sacrifice for what they believe — he deserves to be rewarded.”

Frohsin – a veteran federal prosecutor and litigator of more than 40 years – left a large defense firm in late 2008 with Jim Barger and Elliott Walthall to form Frohsin & Barger, LLC to represent whistleblowers in qui tam actions across the nation under the False Claims Act.

“Less than a year later, we met Carl,” says Jim Barger, Crawley’s qui tam attorney. “He’s one of the most humble, soft-spoken people I know. The day we told him he’d be receiving an award from the Rural/Metro settlement – one of his first questions was to ask if Frohsin & Barger would sponsor the pee-wee football team he coaches, because they needed new uniforms.”

Whistleblowers like Crawley are central to eradicating fraud in government spending programs – particularly Medicare and Medicaid. Earlier this month, Attorney General Eric Holder praised whistleblowersfor recovering “more than $21 billion” in taxpayer dollars over the past 25 years. In his June 7 report to Congress, Holder called the False Claims Act “an effective tool in getting at fraud, and incentivizing people to stay involved in the process.”

Carl Crawley is pursuing a B.A. in criminal justice after sacrificing his EMT career to expose what he believed was Medicare fraud.

And the “process” can be grueling. Crawley’s allegations remained sealed for over a year while the government investigated, according to court documents. Initially declining to make a decision, the government intervened in March 2011 with a complaint filed by U.S. Attorney Joyce White Vance, echoing many of Crawley’s concerns. Thereafter, the company took fifteen months to settle, admitting no past wrongdoing but entering into a corporate integrity agreement to curb any future Medicare ambulance fraud.

Rural/Metro is a national for-profit medical transportation provider headquartered in Scottsdale, Arizona. Previously a publicly traded company, Rural/Metro Corporation was acquired in June 2011 by NY-based private-equity firm Warburg Pincus.

To report Medicare Ambulance fraud or other healthcare fraud under the false claims act, contact Frohsin & Barger.