Re: IRS looks into 2 ambulance firms for possible Medicare fraud

December 15, 2005

OK, soapbox time again.

I have no idea whether these ambulance firms are guilty or not,

that's for the Feds to figure out. What I want to know is why that,

everytime the Feds move in to investigats this stuff, it's all over

the news. Ambulance firms, hospitals, doctors, etc, etc, ad nauseum,

but never a word about the people that commit Medicare and Medicaid

fraud every day.

You all know the ones I'm talking about. The ones that use the

ambulance as their personal taxi or that use the Emergency Room as

their primary care physician instead of going to a clinic or Doctor.

Back when I worked in the Emergency Room, I have actually had people

tell me that they came there because they wouldn't have to wait like

they did at the clinic. Never mind that the bill to Medicaid is

going to be 10 times what it would have been, they didn't want to be

inconvenienced.

There was a move awhile back to make people on Medicaid that went

to the ER for non-emergencies pay a copay. Thie was squashed by the

know-it-alls in Washington because, they said, it would deprive

children from getting needed medical care. Give me a break. It would

just make Momma and Daddy get off their lazy butts and take the kids

to the clinic during the day instead of wating until the kid got so

sick he/she kept them awake at night. Excuse me, but a sore throat

that the kid has had for 4 days is NOT an emergency and should have

been taken care of a lot earlier. As long as we let these people get

away with this crap, they'll milk it for all it's worth.

I'll climb down now and give somebody else a chance. Sorry for the

tirade folks. This is a subject that really ticks me off in case you

couldn't tell LOL.

Again, Merry Christmas Y'all

Joe

>

> Subject: DeSoto: IRS looks into 2 ambulance firms for possible

Medicare

> fraud

>

> IRS looks into 2 DeSoto ambulance firms

> Inquiry appears to focus on Medicare fraud allegations

>

> 12:00 AM CST on Thursday, December 15, 2005

> By HOLLY YAN / The Dallas Morning News

>

> The IRS is investigating at least two area ambulance companies,

> apparently for possible Medicare fraud.

>

> The Internal Revenue Service and other authorities searched

Citizen's

> Care Ambulance Service in DeSoto and Doctor's Ambulance in DeSoto

on

> Wednesday. Officials seized computers and records from Citizen's

Care

> and towed about six ambulances from Doctor's.

>

> Corcoran, a spokeswoman for the IRS, said she could not

comment

> on an ongoing investigation and said official comment would have

to

> come

> from the U.S. attorney's office. Kathy Colvin, a spokeswoman for

the

> U.S. attorney's office, could not be reached for comment.

>

> DeSoto police Capt. Ron said his department assisted the IRS

in

> the investigation at Citizen's Care. He said the investigation

appeared

> to focus on allegations of fraud.

>

> The president of Citizen's Care, Tony Wilkerson, said he's not

> surprised

> by the investigation.

>

> " I have disgruntled employees, " he said. " I'm not an easy person

to

> work

> for because my expectations for people and what we do around here

is

> very high. Nobody likes my demeanor. I'm very arrogant at what I

do. "

>

> Mr. Wilkerson said his company serves private clients, especially

> elderly patients with chronic health problems, and does not work

for

> local fire departments.

>

> He said he has never participated in Medicare or Medicaid fraud,

which

> he said sometimes involves offering patients kickbacks for

services or

> changing records to appear to be eligible for government

reimbursement.

>

> " In the private ambulance business, we deal with Medicare and

Medicaid

> on a day-to-day basis, " Mr. Wilkerson said. " Medicare has to make

sure

> everybody's on their p's and q's. "

>

> Mr. Wilkerson said officials did not order him to close his

business

> Wednesday. He said he was not sure why his friend Anura Andradi,

owner

> of Doctor's Ambulance, was forced to close after his business was

also

> searched.

>

> Mr. Andradi declined to comment on the investigation. Mr.

Wilkerson

> said

> he is working with Mr. Andradi to determine how Doctor's

Ambulance's

> regular clients will receive care.

>

> Staff writer Herb Booth and Bert Lozano of WFAA-TV (Channel 8)

> contributed to this report.

>

December 15, 2005

I agree that there are a lot of people out there who do not correctly use health

care services. However, to me, fraud implies deliberate actions to mislead. I'm

not sure how calling 911 or making an ER trip constitutes fraud. However,

billing the government for services not actually provided does constitute fraud.

As for the individuals who misutilize EMS and the ER, aren't we failing as

patient advocates when we don't explain their options to them? I'm never opposed

to transporting or treating a patient, but I want them to be informed as to

their options. I've been known to tell someone, " All we're going to do is give

you a very expensive ride. "

Happy Holidays, (there are a few of us non-Christian heathens out there....)

Wes Ogilvie, MPA, JD, EMT

Austin, Texas

DeSoto: IRS looks into 2 ambulance firms for possible

Medicare

> fraud

>

> IRS looks into 2 DeSoto ambulance firms

> Inquiry appears to focus on Medicare fraud allegations

>

> 12:00 AM CST on Thursday, December 15, 2005

> By HOLLY YAN / The Dallas Morning News

>

> The IRS is investigating at least two area ambulance companies,

> apparently for possible Medicare fraud.

>

> The Internal Revenue Service and other authorities searched

Citizen's

> Care Ambulance Service in DeSoto and Doctor's Ambulance in DeSoto

on

> Wednesday. Officials seized computers and records from Citizen's

Care

> and towed about six ambulances from Doctor's.

>

> Corcoran, a spokeswoman for the IRS, said she could not

comment

> on an ongoing investigation and said official comment would have

to

> come

> from the U.S. attorney's office. Kathy Colvin, a spokeswoman for

the

> U.S. attorney's office, could not be reached for comment.

>

> DeSoto police Capt. Ron said his department assisted the IRS

in

> the investigation at Citizen's Care. He said the investigation

appeared

> to focus on allegations of fraud.

>

> The president of Citizen's Care, Tony Wilkerson, said he's not

> surprised

> by the investigation.

>

> " I have disgruntled employees, " he said. " I'm not an easy person

to

> work

> for because my expectations for people and what we do around here

is

> very high. Nobody likes my demeanor. I'm very arrogant at what I

do. "

>

> Mr. Wilkerson said his company serves private clients, especially

> elderly patients with chronic health problems, and does not work

for

> local fire departments.

>

> He said he has never participated in Medicare or Medicaid fraud,

which

> he said sometimes involves offering patients kickbacks for

services or

> changing records to appear to be eligible for government

reimbursement.

>

> " In the private ambulance business, we deal with Medicare and

Medicaid

> on a day-to-day basis, " Mr. Wilkerson said. " Medicare has to make

sure

> everybody's on their p's and q's. "

>

> Mr. Wilkerson said officials did not order him to close his

business

> Wednesday. He said he was not sure why his friend Anura Andradi,

owner

> of Doctor's Ambulance, was forced to close after his business was

also

> searched.

>

> Mr. Andradi declined to comment on the investigation. Mr.

Wilkerson

> said

> he is working with Mr. Andradi to determine how Doctor's

Ambulance's

> regular clients will receive care.

>

> Staff writer Herb Booth and Bert Lozano of WFAA-TV (Channel 8)

> contributed to this report.

>

December 15, 2005

The president of Citizen's Care, Tony Wilkerson, said he's not

surprised

by the investigation.

" I have disgruntled employees, " he said. " I'm not an easy person to

work

for because my expectations for people and what we do around here is

very high. Nobody likes my demeanor. I'm very arrogant at what I do. "

Gee---Could this guy's attitude as a manger have anything to do with

why so many people get out of EMS????? Someone managing/directing other

healthcare services or even a cracker factory will read this and think,

" EMS must be a real Bozo hatchery " .

-MH

December 15, 2005

There's a moral to this story.... disgruntled employees are a wonderful source

of information for investigators.

-Wes Ogilvie

Re: IRS looks into 2 ambulance firms for possible Medicare

fraud

The president of Citizen's Care, Tony Wilkerson, said he's not

surprised

by the investigation.

" I have disgruntled employees, " he said. " I'm not an easy person to

work

for because my expectations for people and what we do around here is

very high. Nobody likes my demeanor. I'm very arrogant at what I do. "

Gee---Could this guy's attitude as a manger have anything to do with

why so many people get out of EMS????? Someone managing/directing other

healthcare services or even a cracker factory will read this and think,

" EMS must be a real Bozo hatchery " .

-MH

December 15, 2005

" Hudson " <mhudson@m...> wrote:

>

> Gee---Could this guy's attitude as a manger have anything to do with

> why so many people get out of EMS?????

Absolutely. But I think you are probably looking at it backwards.

First of all, he's not in EMS. It's a transfer service. And second,

I don't know this gentleman personally, but I do know the type of

lazy, immature, uneducated slug that constitutes the great majority of

EMT transfer jockeys in this state. Based upon that, I tend to

believe that most of them leave because they are not up to the level

of professionalism expected of them by their employer, and not vice

versa.

Not that there is any shortage of reasons to get out of EMS.

Rob

December 15, 2005

" Kim " <kim@w...> wrote:

>

> I couldn't let this go uncorrected.

>

> In front of me is a recently issued TDSHS license that (beyond the

> name of the service) reads, " has submitted acceptable evidence of

> compliance with the Texas Health and Safety Code, Chapter 773, the

> Texas EMS Act, and is hereby granted a License as a TEXAS EMERGENCY

> MEDICAL SERVICES PROVIDER. " All capitializations are present on

> this document as written... I did not alter the words.

Allow me to correct your correction. You're talking semantics. One

only need look at the Texas LP to see just how seriously DSHS really

takes the term " license. " And what you are licensed to provide and

what you actually provide may well be two completely different

things. I am licensed to fly airplanes, but I haven't done so in over

a decade. Similarly, transfer services are not providing EMS,

regardless of their licensure.

Rob

December 15, 2005

" Kim " <kim@w...> wrote:

>

> I couldn't let this go uncorrected.

>

> In front of me is a recently issued TDSHS license that (beyond the

> name of the service) reads, " has submitted acceptable evidence of

> compliance with the Texas Health and Safety Code, Chapter 773, the

> Texas EMS Act, and is hereby granted a License as a TEXAS EMERGENCY

> MEDICAL SERVICES PROVIDER. " All capitializations are present on

> this document as written... I did not alter the words.

Allow me to correct your correction. You're talking semantics. One

only need look at the Texas LP to see just how seriously DSHS really

takes the term " license. " And what you are licensed to provide and

what you actually provide may well be two completely different

things. I am licensed to fly airplanes, but I haven't done so in over

a decade. Similarly, transfer services are not providing EMS,

regardless of their licensure.

Rob

December 15, 2005

Rob -- just to play semantics here (it is what lawyers do after all), is it

possible that the real problem is the name EMERGENCY Medical Services? After

all, many 911 calls aren't truly emergencies. For example, is the patient who

calls 911 for a chest cold more of an emergency than the 85 year old female

" merely " transferred from a small-town hospital to a large academic medical

center due to an acute MI which needs bypass surgery immediately?

We're all prehospital providers, right?

-Wes

Re: IRS looks into 2 ambulance firms for possible Medicare

fraud

" Kim " <kim@w...> wrote:

>

> I couldn't let this go uncorrected.

>

> In front of me is a recently issued TDSHS license that (beyond the

> name of the service) reads, " has submitted acceptable evidence of

> compliance with the Texas Health and Safety Code, Chapter 773, the

> Texas EMS Act, and is hereby granted a License as a TEXAS EMERGENCY

> MEDICAL SERVICES PROVIDER. " All capitializations are present on

> this document as written... I did not alter the words.

Allow me to correct your correction. You're talking semantics. One

only need look at the Texas LP to see just how seriously DSHS really

takes the term " license. " And what you are licensed to provide and

what you actually provide may well be two completely different

things. I am licensed to fly airplanes, but I haven't done so in over

a decade. Similarly, transfer services are not providing EMS,

regardless of their licensure.

Rob

December 15, 2005

Rob -- just to play semantics here (it is what lawyers do after all), is it

possible that the real problem is the name EMERGENCY Medical Services? After

all, many 911 calls aren't truly emergencies. For example, is the patient who

calls 911 for a chest cold more of an emergency than the 85 year old female

" merely " transferred from a small-town hospital to a large academic medical

center due to an acute MI which needs bypass surgery immediately?

We're all prehospital providers, right?

-Wes

Re: IRS looks into 2 ambulance firms for possible Medicare

fraud

" Kim " <kim@w...> wrote:

>

> I couldn't let this go uncorrected.

>

> In front of me is a recently issued TDSHS license that (beyond the

> name of the service) reads, " has submitted acceptable evidence of

> compliance with the Texas Health and Safety Code, Chapter 773, the

> Texas EMS Act, and is hereby granted a License as a TEXAS EMERGENCY

> MEDICAL SERVICES PROVIDER. " All capitializations are present on

> this document as written... I did not alter the words.

Allow me to correct your correction. You're talking semantics. One

only need look at the Texas LP to see just how seriously DSHS really

takes the term " license. " And what you are licensed to provide and

what you actually provide may well be two completely different

things. I am licensed to fly airplanes, but I haven't done so in over

a decade. Similarly, transfer services are not providing EMS,

regardless of their licensure.

Rob

December 15, 2005

ExLngHrn@a... wrote:

>

> ...is it possible that the real problem is the name EMERGENCY

> Medical Services? After all, many 911 calls aren't truly

> emergencies.

But the response is. And, unless you are the Dallas Fire Department,

the place to determine whether or not an actual medical emergency

exists is on the scene. Scene response = emergency. Unfortunately,

as points out, the general public has no idea or interest in

the semantics of the ambulance business. But I wouldn't use that as

an excuse to dumb down our operations.

> We're all prehospital providers, right?

Absolutely! But that circles back to the same question: Providers of

what? Transportation? That's about the only common denominator.

Which goes back to the core issue of whether or not all these taxis

should be required to license as " EMS " providers simply because their

passengers don't sit upright.

Without E and M, you are not providing EMS.

Rob

December 15, 2005

Rob, allow me to correct your correction of Kim's correction. It is

YOU playing the semantics game. The law is the law is the law. You can

spin it however you want and it matters not an iota if the service is

a fire department, a hospital, or the skankiest transfer service,

under the LAW they are EMS and must ALL meet the same burden. You may

WISH it were otherwise, but that has never helped in the past, has it?

Even this lowest of the low rent services is required to meet the same

standards as the first rate fire departments (if such a thing exists).

Now, speaking for the manager (he called himself president, didn't

he?) of this Citizens Care outfit, Mr. Tony Wilkerson, I can tell you

a little. I never worked for Citizen's Care but I work now with a very

fine paramedic that once did work for the gentleman. She tells me she

worked all of two weeks then quit because of the condition of the

ambulances and the equipment. She told me when she complained that the

ambulances wouldn't meet code, Mr. Wilkerson called her everything but

a nice girl. She walked out leaving her paycheck behind fearing for

her safety. Mr. Wilkerson scared her enough she didn't care if she got

paid.

Disgruntled employees? I don't doubt it.

--

>

> Allow me to correct your correction. You're talking semantics. One

> only need look at the Texas LP to see just how seriously DSHS really

> takes the term " license. " And what you are licensed to provide and

> what you actually provide may well be two completely different

> things. I am licensed to fly airplanes, but I haven't done so in

over

> a decade. Similarly, transfer services are not providing EMS,

> regardless of their licensure.

>

> Rob

>

December 15, 2005