COMMmWBALTII OF MASSACHUSETTS
SUPBUOR COURTDBPAR'IMENT
CIVIL AC'IlONNO.

20
BRENDAN CAMERON.

....-

e~'""
~-..> !i
r'"Tl
:;x_.,

'PJainri~

§ ..
-

Cl'\

n::r.
o"'l :2
e n

v.

zo

-tC

BRBWS'TBRAMaULANCE
SBR.VICB. INC.

-<::C

~

1,'>

~

<"":

:-!

<.
,...,
0

-W*

~

~

r-

C)

r-

U>

DefendlUll
CQMPLAINTANQ JURY Dl!ft\NP'
'1bi$ 4 a whistleblower action brought by Plaintiff Brendan Cameron against his former

emproyer, Brewster Ambulaooe Service, Inc.• for monetary damages. 'The Plaintift's claims arise
out oftbc Defcmdant"s wrongful termination of the Plaintiff's employment

1.
1.

PARTIES

Brendan Cameron is an individual who resides in Quiooy, Norfollc County,

Massacbuseus.
2.

Brewster Ambulance Service.lPC. (tbe ..Company") is one of the largest ambulance

service companies in New England with 15 regional locations in Massachusetts including its
corporate headquarters located at25 Main Street, Weymouth. MA 02188.

n.
3.

.JURISDICTION Ah'D VENUE

This Coun has personal jurisdiction over the defendants pursuant to MG.L. c.

n3A§2.
4.

Venue is proper under M.O.L. c. 223 § l.
W.

.5.

ALLE.GA TIONS AS TO ALL COUNTS

Mr. Camc.'Ton has an extensive background in revenue cycle

proce~s.

medical

billing ;md compliance specifically in tbe EMS industry. Prior to joining tbe Comp~~ny, Mr.

 Cammon tnweUed the country configurina t'MS medical billinJ ~

ud couultiag

OD

proocdural incfficienciel atow.r a buruhcl EMS aaeorJes. Duriftg this time hoauined Ccnificd

Ambullncc Coder and Cadilied Ambul.clm;e Compliance Officer catiftcatiOil&.
6.

T.hrougb his uaining mel prior wort cxperieoce. Mr. CU~Cron fmniliari2ed himself

with Medicaro and Medicaid guidelines regarding appA)priate billing of glaims. He provided
guidance to his cliClttS when he found situations that were questionable.
7.

Mr. Cmeron bepn worlcins for the Company as a Billing Consultant in tbe

soouner of2.019. Shortly into the consulting relatlonship MT. Carne«>o was overseeing the entire
biUing department. and the Company offered him a full-time position which he did not~

8..

On or ;uound October 1, 20l9, Mr. cameron agreed to accept the full-time offer

and was hired as tbe Director of Revenue Cycle with the Company. Mr. Cameton's compensation
pacbge wus robust and included, but was not limited to, a base salary of $120,000 per year. a
living-.expensc stipend of $1500.00 per month for tbe first year of employment and a company
vehicle whose associated costs (fuel and maintenance) were paid by the Company.

9.

In his role as Director, Mr. Cameron reported to the Chief Fina~al Officer

("CFO'') and was responsible for "managing all functions of the billing office and revenue cycle
ensurin~ Oll$h flows are ma)(1mi1.ed and that all intern&\ and eldemal customer relations arc being

maintained."

10.

Mr. Cameron managed a team ofover 50 employees. 6 of whom he had established

as mnnasers for each ponion of his department: Intake, Coding, Claims/Follow Up, Training/QA
~n<l llfl Onlo¢ ~a~ager. The Tr~irtinQIQA manager's role was to perfoma the initial training and
II
I
®board ins ot 11CW h.iTes. Addi1ionolly, sbe wns tasked with continuous QA and compliance checks
on cl&ms b11ing billc:d. Mr. Camc:ron's gu11l was to cr.:ate cunsistoocy and establish a system for
internal auditing and r~ion.

 oompllanoe pmJrtlll inldati~ were momtoi'Cd aad completed. mooitoriDJ quali(y •urnoe to

.R&td that oltt.. ~e tent oui tim.ty &Dd ICC~ty aod to acnmlly raaimaiD compiM!Ule aad
HlPAA ~~~hati~•·
11
Mt. ClroeroD 'Will member oftl'le organizational Loldorahip Team end bad IUrina
1

A

authority and full ~isciplimuy discretion.
13.

ln his first month of full-tlmo employment, Mr. Cameton dixovered over SSOO,OOO

w9rih of overp!lyiJtcots ~hat had not been handled by tba Company dating baok to 2017. Mr.
Cameron advised his staff that refunds would need to be made to the various payors including, but
1101 limited to, M~icare and Medicaid.

14.

ln early November, one of the Company's owners and executives made it known

to top level managers and executives that he hod to put $4,000,000 of his own money into the

Company to maintain 1ts solvency (the "Owner/E.xeeutiv~"). At that time, he also infonned tho
employees in the Onance departmellt tJ1at he would be taking it over.
15.

Around that same tune, the Brewster ownecs, the CFO, CHRO, COO, Chnical

Director and Mr, Cameron oil we11t to Nashville Cor tho American Ambui811Ce A.11sociation
Conference; the event wn!t a ~uccess and a strong team-building experience.
L6.

When Mr. Cameron returned to work he began revieWing dialysis claims. Mr.

Cameron's Compliance Manager had been reviewing the Company's dialysis patients at the
reque..<~t ora Ruhordlnate who wns responsible for billing those patient!' claims. The Compliance

Manager had determined that there W'-'tC nwnero~ patients who did not have paperwork indicating
a medical neces$ity fl)t' ambulance transportation, a requirement for Medicare bcncfaciarics
seeking coverage under tho ML:dic:.ro Prugmn.
I
I

 11

il ill!

II

Specifically. Mcdicm will mt cover tbo to1t of ambrJiaDce 111D1portation UDJcss
I

tbet:v ia dooum.entation tbatlhe traftsport is medica1ly t'tft!ODihle

and ~•IIY·

Motoovw,

Mcd.ica:rc will not <:OVer tbe ~sport if some means oftnmapo.r11tion O(bcr than ambulalwo could
be~ without endlmcerins

the boncfici~s health, reprdlesa of whether tbc other meaJI$ of

, transportation is actually available.
13.

Mr. ClmeroD noticed 1bat many of1be dialysis patients• medical documentation did

not~~ MedX;are standard {becau&ethe)t were capable ofMlkini or lining up on their own,

which was dooumented in the EMT namtives) and should not have been billed to MediQre.
L9.

Thoro

aro diffen:at biUi.ng codes and rates for patients

who rnedicalJy require

ambulanoe transportatioa. For example, wbcn a medically necessaty patient is 1ran:Sported via
ambulance for a dialysis transport. Medicare will reimburse the provider at approximately S200.00
base Jate and $6.00 per mile. When an ambulance bansport is oot medically necessary and the
patient is. instead, transported in a parotronsit verucle, colloquially known as a "'Chair Car,"
Medicare will not pay for that lrip. If the patient has M1$:ihealth, the trip would be covered, and
the provider would be reimbursed at approximately $40.00 base rate ond $1.50 pet mile.
20.

Mr. Cameron brought the dialysis claims issue~. Md other improper billing

practices. to his bos.~. the Owner/Executive. Th.c Owncrletecutive disagreed with Mr. Cameron
and strongly argued thu~ lhe patients at issue required amb1,.1lanoe trllllSport. Mr. Cameron advised
the OwncrfExccutlvc that this was a compliance issue and that these patients' transport.~ should

not have been billed to Me<iicare given the narratives in their Iiles. Mr. Cameron advised the
Owner/I:!:)Cecutive that regardle~~ of the vehicle u.c;ed for transportation, Intentionally bilhng claims
at~ 11isber level

2 l.

where medical necessity was not documented wa~ fraudulent.

On or about November 1.1!, 2019, Mr. Cameron hpd a falling out with the Ditectoc

ufBIISincss Dr:volopmtml, the COO und t1w Owr1cr/Exct--utivc n."gVdin,g
.
the fact lhRl m~:~ny ufthe

-1-

 ,, ~"" ~ ~ u, W. fbr tho~~~- Mr. OUI~ lllftWJned the·~'* of' the meetlnltHtt

tbe.re ~ ICvtt&ll• 'entt who t.d thw (ln)blem1ancl \h•t tMir ICIVIoo levole (nanmoua ~ ~

11

··
r
dlablla ippolntmontl oaob week) ncOOod to be chlnJCd and tbo payment~ rtftlndeCI 16 Medicero
·

lad OllKer paycm.
22.

Thct dl•cUI.IIonl co,._Unucd throuah®t the m()nth of Novembct .md Mr. Clrn.eron

wuldanu1al.tbet Ute billina praotlC* were improper aod that monies needed 10 be refunded to
Medicare and other payo11.

2!.

Mt. CuMt<m was than instnlcted 'o atop readina patient nanatives wbenreviewiaJ

o!aim.11 for pro~estlQs so U1~ olairn~ CllO!.Ild be procened faster. Mr. Cameron pul!u!d baolc lbd
informed the Owner/Bxecutive that biUiog Medicare (and other insuraoce providers) without
reading rthe narrative would be fraudulent because it would be impossible to dctennine whether a

pe,tiant's ambulan~ transport was tntdically nece8sary without reading tbe narrative.
24.

Mr. Cameron took this issue to the CFO aud explained to her that tho orders he was

rcceivins from the Owncr/Exocutivo were not in compliance with Medicare gu;dclincs, and put
the Company at major risk as the activity was fraudu\ont
2S,

By the end oC November, the Owner/&eeutive made aggressive obanges fo the

billing departments• process and its stan: Specifically. on November 27,2019, Mr. Cameron was
I

instructed to lay otT 9 of hls stat! members to "reduce costs." Mr. Cameron disagreed as the
s~mnslnt.~mhers were appropriate fo~ ttie volume of work at the Company.

I

~

~

I
ll

26,
On or ~!-bout J)ecetl\bet 3, 2019, Jhc CFO ~ent an email to the owners of the
II
Compclny, the COO ond Mr. Cameron wherein she lllated that (like Mr. Cameron) 11he fult the new

Iil

II ~~~lti~~ ~u1~$t> (ri~t

1

teading the nacrati~~) would put the Corti pany at a compliance risk. The CFO
1

1

 Ill

J..ctJ JIMfal documeats to tbe email wid~ "Dowmcntatioo OuideliDca,,. "Do~~

n

~arTMivo Bumple8~" and "Medicare Doc:umenbltfoD., to llluttrate the tsne~llld ber poiDt

z:;,

At that same time. tbe Owoer/BxeQ.rtive infotmed Mr. Cameron 8Dd the others i.b

~ hts ~·IUJet that. eoing foMard. DO olaiml were to be refunded to Medicare (4)t other payOI$)

W~nleJ~t.e J~ a~d -

Prior to tblt pOint Mr. Camolon bad authority to rcftJnd

ctalm8 ~ felt were improper.
28,

Mr. Cauteron and hia manqer1 posbed back on that issue as well and. u a ~t

the Owner/Executive began conducting meetiop regarding the billios depactmenl with staffen
(t~e IT Director, the Dispatch Manager and

his executive assistants) wbo had nothing-to do with

'II b~l,.~ns ~r coropl~e.
29.

Ov« the next two weeks, the Owner/Executtw had secret meeting$ witb. various

employees and decided 10 split tbe billing department into two teams; one employee would be in
charge of Team A and Mr. Cameron would be in charge of Team B. Team B was only responsible
for work denials and foUow-up on unpaid claim~ significanl demotion from l.bc job description
~r.

Cru;wteron

wn$

give:o when hired full-rimo-wbieh kept him away from the Medicare

oompliamc:e issues ho had complained about.
30.

On or about December 20. :2019, the CI10 save Mr Cameron permis:;ion to work

remotely over the holiday break; she informed Mr Cameron ttud lhc 0\o\-'llerfE)(C(;utive's secretary
would rn:ed to be notified. The secretary then informed Mr. Cameron that he would need to speak

with the Owner/Exec-q.,tive. The OWller/1-!xecutlve was not available so Mr. Cameron received
a~proval frqm hjs $j>lt, llle c~ of~te Company,

3 l.

When Mr. C1U1'1er<m returned to wnrk in the office in January. 2020. he was

infonned Chat the Owner/Executive was upset that Mr. Cameron had been working remotely (even
tbouah his son. the CEO had approved the reque$t) and contended that Mr. Cameron had not done

 anythiq for tho departmertt OXQO(X "wruc off money.• The OwDctiBxccutivo Also aoou.sed Mr.

Cameron ofce11&ing disseDt IIJl008 the smff iD 1he biDing~ who were U]BCt about all 1be

obaaaes he had mada (as vn~U as tho ftaudulem billing prac:OCC$ Mr. Cameron had broo,ght to
evcryl)no's attenfioo). Mr. Camcro11 was tben 1mninated from die Company.

COUNT I

32.

Tb&Plaimiffrepeats andtealltges tboallegationsconlaincd in pam.graphs 1 through

31 of tbe Complaint as ifset forth betein.

33.

Mr. Cameron dl$olosed the sipificant Medicare compliance issues (filmd) wi1h tb.e

Com~' !i billing practices to his

supervisor end was, in tum, stripped of his job re$pOBSibiJities

and then tenninatedin violation ot'M.G.L. ch. 149 § 185 (bXt) and public policy.
34.

As. a cfucct result of the Deftmdant's wrongful conduct, the Plaintiff has suffered

and will oontin1le to suffer including, but oot limited to, past and future wagts, loss ofopportunity,
and emo1iontd distress.

COUNT«
\VronKlul Termination. (~od' Faith and :f'ajr Dtallng
35.

ThePI:aintiffrepeats and real leges the ~tllegations contained in paragraphs J through

.34 of the Complaint a.' if set forth herein.
36.

A covenant of HOOd faith and fair dealing is implied ln cvezy employment

tclationehip in Massachusc..115.
37.

1'hc Company had an obligation to refrain from doing any act that would deprive

the Plniotiff of the benefits of bis employment relationship with the Company,
38.

The Plaintiff reasonably relied on the Company to enforce & policies and

proceduces in a fair and equitable manner.

 39.

Tho PlllialifffulfiUc:d a1J of hi! duties UJd ~·of cmploymcnL

40.

The Compatty b..ad tbe implied CO¥caant of goacl &it at2d fair dealing w1m it

tcrmimded Mr. Cameral. in bed faith.

41.

M a direct a prmdmate Je$Uit ofkDcfbtdtmt's brc.chof1bD implied~

of aood faith and filir doalina. 1hc Plainti.ft' bas sutrered and cmttlnues to sutra- 'ores. economic
hardship and damages.

WHBRBPORB, Brendan Cameron I"CCpectfully prays that tbe Court

I.

F.mr judgment in favor of Cameroo on all

COdlll$

f88inst B~ Ambulmc:e

Service and award damaacs to be dc1eJ mined at trial;
2.

Award tM Plaintiff 11ueo times lost put and ftuure wages, benefit! mdl other

nmumeration and interest thereon;

3.

Award lbe Plaintiff' his attorney'! fees, costs and~ post

4.

Entermch other reliefu it deernsjustandproper.
IV.

JURY DEMAND

BrendaCameron hereby demands ajwy ltial

La

. Madar, BBO No. 654326
ftices of Serena D. Madar

._-""~'.112 HanoockStreet,
Quincy~ MJ\ 02169

(6l7) 308-1627

sdm@madartaw.com

SuiteLLlO

 n.. SUportor Court

005 9

20

TYJ!e OF AcnOf,l ('!*~
Wllafwbl- 'VIRnigiJl Tllnnlnellln

~~~~- • full\ lle1111l.d •d ch&lllld :abltemtllt oflle laCIII on~ thtt u~nl!!d plt/n'lllr Of pi*IIT eDIIIIh! N!lt~ 110 dtMtmht nocm•r chumgve. f"llf
form, clllft.-rd daul*cr lrotlle d~ -~ IMtow ~ dllmt;t• only.

TORTS tUM

(declt IICIIWonlll-.. H n - v )
Oocunen..d medlcllll'llpel- $0 date:

1. TOI.IIIloapllal "JI!lll- ----~-·-··-·--·-·-·--···-~-·--~
2. TOIII dllddr upeMet ·~----·--·-·-·---·-·-·-·-·-·-·
·--·-··
a. TOIII ctlliOprectio CICp!lll8fi ·-·-·-·-·--·-·-··-..- - . - - - - · ·-·----·--. . ...01. physlo;tlflw~ ..P - · ·--... ~·-·-··..--.. -·-~---· ..
·------··----~--·-~·

-a.

&. To1JI Q~t~..-•JC~ (dnwib• btlowY) ••••• _ ............... _______

· .~----·-·--·-·--·--·---~CAl:

~"'~···
··-·--·--·-··-·--··-··-·-•-•f""'o' ""'•·
Documented propeny damages 10 dMed ..........- ...............- .................. ...................................................- ..•.- ..........- .. _·-·-·-·

..····--·-·.

Doa~rne:nttd fot.l: v.reg&8 end C:O!'n;pitnealon to elite -··-· ..···-"~·· ..··-··-··-··-·"'···-'iJ··-.~···ll---·

Ae>o&onebly llflliclpoled flllur& medical and. h~lt:ai8Qql811- ........................~ ...................._.......m

Rc:M-On.Rbfr nntl~ l~t .,...liei .,,,...,...,_.....,,,f!l,lf+l ,...................................

"~"-'""-""'"

.._ ,_ _. . . . . . . . . . . . . . . .

on... _ _.,................................................ _, _ _. ., _ , . _ , _ , _ ,.................. .

C»>et dooumCilted ilcmt or ~II'IIIIJC$ (des tribe below) ............. ····-~ ..- .... - .....- ...........,_., ....- .-...........,_._.._,____

MD'<fn9 el>d relocaeo,.. C7Penks

r•·uo•u···-·-·-

$
$
$

,:
$

s
s

•
$

TOTAL IA..f):S
CON'IBACT ClAIM I
(eltlctl edc111oolll shuts.,.,.• ._...._,
.11 dot~~lled

clll'lltrip(on o! cllllrm(s):

1'0TAt.: t

PURSUANTTOs.JC RULE 1:18
I"'<lt~lte'll)l!ii'l\' of Rulo S of the s:oprema JU<i::.al cou:1 Unrfcnn Rule• on CI&J:ule Reaol111ion (SJC
dic:n1.1: wol~.lio,rm·ma,ti0n ;~.bout court·eoMected d·spuce t~sot..110n eervicea and

disarh•.r.l.ag~~~.cn \.1-·.c

~·~hotle e>f di$,."Uie re~~>luUm

dlscusswilh lhem tt..