Mobile Life ambulance company agrees to pay back patients over illegal billing, AG says

• Mobile Life illegally billed patients, the attorney general said.
• The ambulance company, based in Orange County, provides services throughout the Hudson Valley.
• Mobile Life has agreed to pay back patients.

State Attorney General Letitia James' office announced Thursday that it had settled a case of alleged illegal billing with Mobile Life Support Services, a privately-owned commercial ambulance company that serves communities throughout the Hudson Valley.

James said under a practice known as balance billing, Mobile Life would illegally bill patients for the difference between what their insurance plans paid and what Mobile Life charged for services. James said her office began an investigation after receiving complaints from patients who said they were charged that difference.

Some unpaid accounts were referred to a debt collection agency, James said.

Under the settlement, Mobile Life will pay full restitution plus interest to all affected patients, request closure of all accounts with debt collectors and pay a $100,000 penalty.

"Mobile Life Support Services took advantage of vulnerable patients," James said in a statement. "When New Yorkers are in need of emergency medical care, the last thing they should be worried about is being exploited by the very company entrusted with helping them."

A statement released Thursday by Tricia Mood, Mobile Life's communication and legislative affairs specialist, said the billing mistakes were "inadvertent errors on our part."

"We failed to realize that a previous billing practice had not been corrected after a regulatory change, and that subsequent invoicing of some patients was done erroneously," the statement said. "Our computerized billing system would not automatically recognize the error and continued the invoicing of outstanding balances incorrectly, including sending certain 'delinquent' accounts to collections."

"When this was brought to our attention, we immediately stopped the practice," the statement said. "This was not a deliberate act to deceive any patient or to engage in fraudulent billing practices."

Mobile Life is based in New Windsor in Orange County. It provides services in Dutchess, Orange, Rockland, Ulster and Westchester counties. According to James, Mobile Life responds to more than 100,000 calls for service across that region every year. Mood's statement put the number at more than 90,000.

Under New York state insurance law, James said, an ambulance service provider cannot bill a patient who has comprehensive health care coverage the difference between that plan's payment and the provider's charge, other than applicable co-payments, deductibles or co-insurance.

Under the law's ambulance mandate, an insurance provider or health plan is required to pay the usual and customary charge to the ambulance service provider, unless a contract with a different negotiated rate exists. James said that is true regardless of whether the ambulance service is a participating provider in the health plan's network.

James said Mobile Life's documented practice of improper balance billing also impacted patients' credit.

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An independent auditor, retained and paid for by Mobile Life, will review all payment records for those assessed the illegal balance billing charges since June 1, 2016 to determine who is eligible to receive full restitution, plus 12% interest per year. For all patients whose unpaid, illegally charged accounts were referred to a debt collection agency, Mobile Life will instruct the debt collector to cease all collection activity, set the balance to $0, and direct credit bureaus to remove any derogatory information reported for the affected person, James said.

In her statement, Mood confirmed that Mobile Life will follow that path.

"We take full responsibility for the error and, working with the Attorney General's staff, have agreed to all refunds and penalties, as well as to hire an independent auditor to oversee the review of cases and any remediation required," the statement read.

In addition to the $100,000 penalty to the state, Mobile Life will be assessed an additional $15,000 for any future violation.

In addition to financial relief, Mobile Life must modify its current practices so that the insurance company is billed in the first instance, and the patient is clearly told they owe only a co-payment, co-insurance or a deductible.

Mobile Life also must develop a training program on the new procedures, and provide it for all current and future staff.

Mike Randall covers breaking news for the Times Herald-Record, the Poughkeepsie Journal and The Journal News/lohud. Reach him at mrandall@th-record.com or on Twitter @MikeRandall845.