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Fallout Over Billing Plan May Reach EMSA CEO

TULSA, Okla. -- For the first time in his 34-year tenure, EMSA CEO Steve Williamson is expected to undergo a personnel review by the agency's board. The Emergency Medical Services Authority's board also plans to vote Wednesday on whether to spend $600,000 on an advertising campaign to educate the public about TotalCare, a utility fee program designed to cover the cost of ambulance service. Both actions come in the wake of a Tulsa World investigation into EMSA's operations and billing practices.

EMSA is a government agency that provides ambulance service to more than 1 million people in Tulsa, Oklahoma City and surrounding cities. Residents in those cities pay a monthly fee on their utility bills -- $3.64 in Tulsa -- for ambulance service. EMSA bills insurance for emergency runs and is supposed to cover out-of-pocket costs such as deductibles through the utility fee. The program is also supposed to provide emergency ambulance service at no charge for those without insurance.

A World investigation found that EMSA has sued at least four people who were paying the utility fee. EMSA sends a bill to all patients, including those in the program, stating "due from patient" and "due upon receipt." EMSA does not advertise the program, and residents receive one annual notice about its requirements in their water bills.

EMSA instituted a requirement last year that patients must submit their insurance information within 60 days or become responsible for the entire bill. The requirement is not authorized by city ordinance and was not approved by EMSA's board. Officials have said they believe that only a few customers have erroneously paid bills they did not owe for ambulance service.

So far, EMSA has refunded payments to five customers and dismissed a lawsuit against a Jenks woman after having garnisheed her pay for a year. Williamson has not received a personnel review during his tenure as the only CEO of the agency, which began in 1977. EMSA spokeswoman Kelli Bruer said EMSA is "regularly evaluated and audited on an ongoing basis" to measure financial and medical performance. EMSA meets or exceeds requirements regarding ambulance response times, records show.

"The results of those evaluations are a direct measurement of Steve Williamson's leadership," Bruer continued. "Steve welcomes the opportunity for the board to review his performance. He also appreciates any feedback they may have on solidifying EMSA's position as a national leader in emergency health care and transport."

EMSA's 11-member board of trustees will meet at 1 p.m. Wednesday to consider several items related to the World's ongoing investigation. The trustees will vote on whether to hold an executive session in Stroud next month to review Williamson's performance, according to the agenda for Wednesday's meeting. Advertising: The board also will consider a contract with Littlefield, a Tulsa advertising agency, to advertise the TotalCare utility fee program. The contract, if approved by the board, would total $600,000 this fiscal year and next. The agenda item states that the contract would pay for public education regarding the TotalCare program, "as requested by the Tulsa mayor and City Council."

City officials have urged EMSA to ensure that citizens understand how the utility fee program works. If trustees approve the contract, Bruer said, residents who pay the fee will have a better understanding of what services are covered. Numerous residents interviewed by the World have said they were billed and in some cases sued for ambulance service even though they were paying the fee.

EMSA also files liens against patients involved in car accidents to enable the agency to collect any insurance settlements. A lawsuit filed by five plaintiffs in Tulsa County District Court alleges that EMSA fraudulently charges and collects for service that the utility fee program is supposed to cover. The suit, filed by attorney Robert Pezold, is seeking class-action status. Travel: The trustees also will discuss travel spending for Williamson's role as president of the American Ambulance Association, a national industry group.

Records show that EMSA has spent about $400,000 on travel, meals and related costs since fiscal year 2009 and that more than a third of that was for Williamson's role as president of the association. Expenses included $500-a-night hotel rooms and a $100 car wash. Williamson flew only first-class, providing a 1984 doctor's note stating that he needed to do so for medical reasons. He has said Oklahoma benefits from his role in the association, where he has lobbied for issues including higher Medicare reimbursement rates.

Other travel and training costs included a $3,000 retirement party for an executive who remained with EMSA as a consultant. The board has since voted to limit expenditures for travel and parties. EMSA CEO Steve Williamson said people who believe they were wrongly charged for services or paid ambulance bills they did not owe should call the agency. He said EMSA will give refunds if that occurred.

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