Medicare fraud costs taxpayers billions of dollars each year, and unfortunately, some providers exploit seniors by billing for services that are unnecessary or never even provided.
Here’s what you need to know to protect yourself and your loved ones.
Medicare Part B only covers ambulance transportation when very specific conditions are met:
✅ The transport must be medically necessary.
✅ Traveling by car or wheelchair van would endanger your health.
✅ It must be the only safe transportation option.
✅ The ambulance and crew must meet federal and local standards, including carrying:
A stretcher
Emergency medical supplies
Oxygen equipment
Emergency lights and sirens
Proper communication equipment.
Covered Destinations include:
Hospitals
Skilled Nursing Facilities (SNFs)
Dialysis centers (for End-Stage Renal Disease patients)
Return trips home when medically necessary.
Not Covered:
Routine doctor appointments
Visits to independent labs
Transportation to outpatient psychiatric centers
Non-emergency trips.
Fraudsters use several tactics, including:
Falsifying medical necessity to bill Medicare
Charging for longer distances than actually traveled
Labeling non-emergency trips as emergency services
Billing Medicare for taxi or van rides as if they were ambulances
Billing you personally instead of billing Medicare.
Be especially wary of “upcoding”, where providers bill for Advanced Life Support (ALS) services even when you only received Basic Life Support (BLS). ALS ambulances must be staffed by at least two certified EMT-Intermediates or Paramedics.
Always review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB) to check:
That the service listed matches what you actually received
That mileage charges match the distance traveled
That no false emergency charges were added
That the ambulance type matches the care you received.
If something doesn’t look right — trust your instincts and report it.
If you spot suspicious billing for ambulance services, contact SMP Hawaii:
📞 Call: 1-800-296-9422
🌐 Visit: smphawaii.org
For questions about Medicare coverage, contact Hawaii SHIP:
📞 Call: 1-888-875-9229
🌐 Visit: hawaiiship.org
Stay alert. Stay informed. Together, we can protect Hawaii’s kūpuna from Medicare fraud.
