Ambulance Fraud

Medicare covers ambulance services when they are medically necessary. To qualify for coverage, the ambulance and its crew must meet certain standards and be the only safe means of transporting a patient to an appropriate facility – like a hospital, skilled nursing facility (SNF), or dialysis center – where the patient receives Medicare-covered services.

Report potential ambulance fraud, errors, or abuse if:

  • An ambulance was not medically necessary, and a wheelchair van or other automobile could have transported you safely
  • You were transported in an unapproved ambulance, like a taxi
  • You see on your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) charges for:
    • More mileage than the actual distance traveled in the ambulance trip
    • Advanced life support (ALS) instead of basic life support (BLS) or if it shows an emergency transport when it was not an emergency
  • Your ambulance was not staffed by two emergency medical technicians (EMTs)
  • You were transported from your house to a non-covered destination like your doctor’s office, a community mental health center, a psychiatric facility (outside of a hospital), or an independent lab not connected with a hospital or SNF

To learn more about tips related to ambulance fraud, click here. To learn how to read your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB), click here.

Report Suspected Fraud

To report suspected fraud, click here.

SMP Resources