EMSA Alters TotalCare Website Info - News - @ JEMS.com

EMSA Alters TotalCare Website Info

Attorneys for six plaintiffs filed a request to amend their lawsuit a second time, clarifying claims against EMSA and its law firm


ZIVA BRANSTETTER, Tulsa World | | Monday, April 23, 2012

TULSA, Okla. -- EMSA has changed the description of its TotalCare utility program on its website since a lawsuit was filed alleging deceptive practices in the program, court filings claim.

Attorneys for six plaintiffs filed a request Thursday to amend their lawsuit a second time, clarifying claims against EMSA and its law firm, Works & Lentz. The amended suit seeks to add new information, including a claim that the firm violated the federal Fair Debt Collections Practices Act.

EMSA and the firm have filed motions to dismiss the case and have denied all of its claims. EMSA and Works & Lentz have declined repeated requests by the Tulsa World for interviews.

In a statement posted on the agency's website several weeks ago, Kris Koepsel, an attorney for EMSA, said: "The facts of these individuals' cases do not support what they claim. Four out of the five individuals have not even paid any money to EMSA, so there are plainly no refunds or damages to obtain. Two of these individuals were clearly opted out of the program at the time of their transport, and two plaintiffs were transported before the city utility fee program began."

The lawsuit was filed Feb. 24 by attorney Robert Pezold on behalf of plaintiffs Priscilla Johnson and Evan Hughes. It later added plaintiffs Robert Mitchell, Turner Everidge and Judith Marshall on behalf of Ellen Moore, who died last year. It is seeking class-action status, a request that has not yet been ruled upon, and damages of more than $75,000.

The suit alleges that EMSA improperly billed patients for services that should have been covered under the TotalCare program. Residents of Tulsa, Oklahoma City and surrounding cities pay a monthly fee on their water bills in exchange for no out-of-pocket expenses for ambulance service under the program.

The suit claims that EMSA failed "to utilize any process of inspection of readily available records" when determining which customers to charge for its services. The amended suit adds new details about each plaintiff's case, including claims that EMSA failed to advise them of appeal rights or how to dispute charges. Customers receive one annual notice about the program's requirements in their water bills.

EMSA has not advertised the program but recently authorized funds to do so. The second amended petition, filed Thursday, claims that after the initial suit was filed, EMSA changed the description of the TotalCare program on its website. The program for the city of Tulsa began in 2007 and was modeled after TotalCare, an existing EMSA program that provides ambulance service for an annual fee.

City officials have disagreed with EMSA over whether the agency can apply the existing TotalCare rules to those paying the fee on city utility bills. A review by the World of former versions of EMSA's website show how language describing the program has changed over the years.

In January 2009, the website contained the following statement: "By participating, you and all permanent members of your household receive TotalCare benefits. This means you would not receive an EMSA ambulance bill if you or any member of your household needed emergency care."

Currently, all patients receive a financial statement that lists the amount "due from patient" at the bottom and "due date: upon receipt" at the top. The statements do not contain information about the TotalCare utility program or indicate that patients may be paying the utility fee and therefore would not have to pay the bill.

More than 80 percent of the single-family homes in Tulsa and more than half of the multi-family homes pay the fee, records show. Another section of EMSA's 2009 website states: "I acknowledge that it is my responsibility to provide EMSA with my insurance and third-party payer information and that failure to do so nullifies this agreement."

Today, EMSA's site states: "I acknowledge that my insurance provider and/or I am responsible for payment of ambulance services provided to me by EMSA. I acknowledge that it is my responsibility to provide EMSA, within 60 days of the date of service, with any valid insurance and third-party payer information pertaining to me or anyone living in my household who receives EMSA services and that failure to do so nullifies this agreement."

The 60-day time limit was not approved by EMSA's board and is not mentioned in city ordinances authorizing the program. Mayor Dewey Bartlett has called on EMSA to end the requirement. EMSA Trustee Clay Bird has said it should at least be subject to board approval. CEO Steve Williamson has said previously that EMSA instituted the requirement because some patients did not provide their insurance information. He said EMSA cannot provide ambulance service by relying only on utility fees.

EMSA officials made it clear during early discussion of the program that insurance would be billed but did not mention time limits, and a spokeswoman said then that patients "would never receive a bill."

More Than One Type of Audit
Tulsa City Council resolution has raised questions over different types of audits after an EMSA executive asked councilors to remove the word "investigative" from the resolution. The resolution by City Councilor Blake Ewing urges EMSA's board to hire either the state Auditor and Inspector's Office or an independent firm to conduct an investigative audit.

The audit should cover spending on travel and capital items as well as billings and collections under the TotalCare program, the resolution states. Last week, Williamson pointing out that the phrase "investigative audit" was in a draft of the council's resolution and requested that the resolution not be written in an "inflammatory" manner. Ewing said Thursday that he wanted the term "investigative" to remain in the resolution, which has no force of law other than urging EMSA's board to act.

The council approved the resolution. State Auditor and Inspector Gary Jones said Friday that an investigative audit by his office probes certain areas of concern and examines whether safeguards and financial controls are in place to prevent waste, fraud and abuse. He said a routine audit by a private firm reviews financial statements to see if they accurately represent the agency's financial state.

EMSA and other agencies that receive a certain amount of federal funds are required to have such audits annually, he said. Audits by private companies and the State Auditor and Inspector's Office differ. The auditor's office charges an hourly rate but does not make a profit off its investigative audits, Jones said.

"We are used to going in and seeing where there's mismanagement," he said.

Audit findings that are criminal in nature are turned over to local authorities. Agencies are given a chance to respond to audit findings before they are released to the public.

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