City Refunds $6.9 Million in Ambulance Fees to Medicare - @ JEMS.com


City Refunds $6.9 Million in Ambulance Fees to Medicare


 
 

Fran Spielman | | Monday, November 3, 2008


CHICAGO -- At a time when Mayor Daley is nearly doubling ambulance fees and struggling to raise dismal collection rates, Chicago taxpayers are giving back $6.9 million in fees already collected for ambulance transport.

On Friday, the City Council's Finance Committee agreed to return $6.9 million in ambulance fees collected from Medicare during the five-year period ending in September 2005.

Corporation Counsel Mara Georges said the dispute with Medicare stems from "three different scenarios," when:

- Transportation wasn't deemed "medically necessary."

- Two people were transported in the same ambulance and Medicare was billed twice for full charges.

- Patient signatures were not obtained, sometimes because the patient was incapacitated.

Fire Commissioner John Brookes told the Finance Committee that 50 of his paramedics had been disciplined for making billing mistakes and that all paramedics and emergency medical technicians had been retrained.

Georges argued that some of the cases were unavoidable.

"Someone got a broken finger playing softball. The Fire Department has to respond. That person says, 'I want to be transported to the hospital.' The Fire Department has to transport. They can't just leave that person there. . . . They bill Medicare. Medicare has come back and said, 'That wasn't a medically necessary transportation. You can't recover for that,' " Georges said.

She stressed the city blew the whistle on itself and conducted its own audit. For that reason, penalties and fines were waived. If the city had not settled, the federal government could have sued for triple damages, fines and costs and could have excluded the city from future Medicare payments.

The costly settlement could not come at a more difficult time. Daley's 2009 budget calls for laying off 929 employees and cutting back city services, eliminating 1,346 vacancies and raising amusement and parking taxes and a laundry list of fees to erase a $465 million shortfall.

Ambulance fees would rise from $325 and $8 a mile to $600 and $13 a mile for basic life support and from $400 and $8-a-mile to $700 and $13 a mile for advanced life support. Non-residents would pay $100 on top of that.




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