Several regions of the country have recently been hit with investigations into falsification of EMS certifications and misrepresentation of continuing education training that was never completed. EMS providers, managers and instructors have gotten in some very hot water. In one recent case, an individual who wasn’t certified as a paramedic started an IV on his girlfriend and was charged with criminal battery.
Failure to maintain proper certification and then functioning only within the scope of practice for that certification is a professional—as well as personal—responsibility of all EMS providers. And every EMS agency needs to be proactive to make sure it employs only certified individuals to comply with state law, as well as the reimbursement requirements for Medicare, Medicaid and other payers.
It may be tempting to be sloppy about keeping current certification, especially when a shortage of qualified EMS personnel exists in some parts of the country. You might think, “Well, they’re too busy to check on it.” Or you may be the busy EMS manager who can’t keep up with all the daily job responsibilities, let alone verifying current certifications.
But the consequences of not maintaining certification are very significant to both the individual and the EMS agency and range from potential criminal charges, civil lawsuits and administrative actions.
Your EMS agency can also be fined or sanctioned by the state EMS office, which can lead to a major public relations nightmare. And if you aren’t properly certified to provide care to a Medicare patient, obligations to refund any reimbursement your agency obtained may exist because of failure to meet the basic “crew and vehicle requirements” of the Medicare regulations that are a condition of payment.
We’ve seen a few cases in which EMS agencies simply didn’t have an effective system in place to regularly monitor certification status of EMS personnel. In a few isolated cases, we’ve also seen certifications lapsed for many months before the agency became aware of it—there’s no excuse for that.
Here are some tips for keeping current and for verifying EMS certification:
>> Know the rules: Although most states follow the National Registry requirements, your state may have different requirements and those rules change periodically, so stay current with the EMS regulations in your state.
>> Check your status frequently: Most states have online capability to check your certification status and continuing education credits. Don’t wait until the last few days of your certification to check and learn you need 10 more hours of continuing education to stay certified.
>> Check official sources: The days of the EMS agency only accepting a paper “copy” of someone’s EMT or paramedic card as verification of current certifications is long gone. These cards are too easy to manipulate or forge. Just about every state has a registry of certified personnel that the agency can check to verify status of certification.
>> Consider EMS management software to monitor and keep track of certifications and continuing education: Some very good “people management” products are available for EMS that can keep track of the various certification dates and current number of course credits with “reminders” to make the process more manageable. This can help avoid lapsed certifications in the first place.
>> Never misrepresent yourself: This can get you in big trouble. Always be truthful about your current certification status when asked by your agency or by any government official. EMS agencies need to be equally truthful when they uncover a lapsed certification. The penalties for misrepresentation can be far greater than if you simply forget and let your certification lapse.
>> Function within your certification: Never provide medical care that is outside the scope of your certification. Make certain that all procedures you perform are approved in accordance with your state EMS law and your medical director.
>> Seek legal counsel: If you learn that one of your staff has a lapsed certification, a whole host of potential legal vulnerabilities exist. The organization could be the subject of a civil suit for negligent supervision or negligent retention of staff. Its EMS license could be on the line. There could be potential “overpayment” issues where your agency may need to refund Medicare or Medicaid if your agency didn’t meet the licensure requirements for a certified crew for the specific transports involving the “lapsed” individual. You need qualified legal advice in this situation.
In addition to checking current EMS certifications, EMS agencies are also responsible to check criminal history information for relevant criminal convictions. You also need to check the federal government database to ensure that the staff member hasn’t been excluded by the federal government from participating in federal healthcare programs.
The bottom line is that individual EMS providers must take personal responsibility for their own certification. EMS managers can’t take a “hands off” approach assuming their staff will maintain current certification as this is an essential element of legal compliance for the EMS agency. The penalties for non-compliance to both EMS providers and agencies are simply too great a risk.
Fortunately, this risk can be easily avoided.
Pro Bono is written by attorneys Doug Wolfberg and Steve Wirth, founding partners of Page, Wolfberg & Wirth, a national EMS industry law firm. Visit the firm’s website at www.pwwemslaw.com.