People who have been in EMS for a while, so called dinosaurs, seem to always lament the passing of the old days. They recall days of yore when equipment, techniques, and even behaviors that are no longer viable were used. To them, all of those things were great and effective. It’s hard to let go and I share some nostalgia for the early days of EMS when there were not so many rules. In fact, there were hardly any.
Times change and EMS has changed, but there are some things you can’t do now. Or at least you can’t do without substantial risk of getting caught and facing some sort of penalties.
In no particular order,
You can’t cheat the federal government. Or the state government, for that matter.
The U.S. Department of Justice, the Washington State Attorney General’s Medicaid Fraud Control Unit, and the City of Everett Fire Department (EFD) today settled all claims that EFD had been overbilling government programs for medical transports, announced U.S. Attorney Annette L. Hayes. Under the terms of the settlement, Everett will pay the two federal programs $127,848, and will pay the Washington State Medicaid program $75,158.
What did Everett do wrong?
According to the settlement signed today, between January 1, 2010, and June 26, 2016, Everett Fire Department personnel submitted claims to federal and state health benefit programs indicating that a higher level of life support service was provided to patients covered by those programs. When the Everett Fire Department paramedics provided only basic life support (BLS), they still coded the claims as if they had provided advanced life support (ALS) which is entitled to a higher reimbursement. Analysts used a sample of claims to determine the damages appropriate in this case.
“Upcoding” as it’s called. Can’t do it. Dallas FD found that out back around 2009 when they were caught doing the same thing.
Here is something else Dallas FD and Everett FD had in common.
Records indicate that a whistleblower within the Everett Fire Department had expressed concern about the routine up-coding, but was ignored.
In the Dallas case, as I recall, the whistleblower tried to solve the problem internally and was fired for his troubles. Which is when he became a “disgruntled ex employee”. Which just about any law enforcement officer will tell you make for great sources of information. Gruntled ex employees are the best kind.
Everett will pay $117,581 to the Department of Health and Human Services, and $10,267 to the Department of Defense. An additional $75,158
will be paid to Medicaid Fraud Control Unit for the State of Washington.
Another article states that the billing company (get ready for that IRS audit) will pay part of this. Also, that the City of Everett paid out more in legal fees than they did in the settlement.
We all complain about it, but you still can’t do it.
JOHANNESBURG, (CAJ News) – SOUTH African authorities have suspended a paramedic who has been caught allegedly using his ambulance as a taxi.
It is alleged the 46-year-old medical worker in the central Free State Province was also drunk when he reportedly transported three passengers. He
allegedly picked up the hitchhikers and drove them to a local taxi rank.
This kind of a two fer as he was also drunk while on duty. Needless to say, that is right out.
This was his biggest crime,
The incident that occurred when he was on duty also incurred the wrath of taxi drivers plying the route the paramedic allegedly operated.
Said cab drivers were mad that he took money for this. So, it’s not like these folks were stranded out in the middle of nowhere.
The investigation continues.
Drug diversion is bad business.
It was like many other opioid-based cases that find their way to Criminal Court. A good person has a life-changing event – most often surgeries –
which results in pain medication being prescribed and the patient becoming hooked.
The addiction leads to criminal activity and lives are changed forever.
For Randy Davidson, the addiction-fed actions came with a steep price. Some might not think the price he is paying is high enough.
Davidson, 48, of Lake Tansi, appeared last month before Criminal Court Judge David Patterson for sentencing after he pleaded guilty in May to official
misconduct, forgery and two counts of theft of less than $1,000.
Lest you think otherwise, it was never okay to steal drugs from ambulances. I’m glad that Davidson was caught.
Here is the part that makes me mad.
Putman sought judicial diversion for her client in hopes that by successfully serving under supervised probation and completing all the
requirements related to diversion, he could not only be restored to the community in good standing but might be able to reapply for the license he
had already surrendered to the state.
Doctors, and for the most part nurses, who are caught diverting drugs (or self report) are not criminally charged. Many are put through rehabilitation programs, have supervised practice, restrictions on their use of drugs that can be abused, and eventually are restored to their previous status. EMS personnel who are caught (or self report) are fired, stripped of their license or certification, and criminally prosecuted. The system has far more sympathy for a drug dealer who is also a user (most of them) than for a person whose life went off the rails due to becoming addicted to pain medications.
For the people who still want to think of EMS as a “profession” keep this sort of thing in mind while you prattle on. While you may think of EMS as a profession, the courts and employers don’t, and won’t cut you any slack at all. Mr. Davidson is now pretty much unemployable at anything above the level of fast food counter help, maybe not even that.
Sadly, Davidson’s story is not at all rare or unusual. I know of several similar cases, including one at my former agency. That one almost cost several managers their jobs and made life miserable for all of the medics for a quite some time.
That’s all for today, because what I thought would start out as a somewhat light hearted post has suddenly made me sad and angry. Not in a phoney Corey Booker sort of way, but in reality.
I’m sure I’ll find more examples of Medics Behaving Badly in the not distant future.