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

[Guest guest]

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

>

> I don't understand all this hostility towards transfer services

> Rob.

What hostility? I have no hostility for transfer services. None at

all. I just said they aren't Emergency Medical Services. I didn't

say that they suck or were doing the work of Satan. Where do you

get the hostility thing?

> We're all playing on the same field here... remove all of the the

> afflilations and types of service, and down deep inside, we're all

> EMTs.

As Mike so eloquently put it here in an earlier thread, it

doesn't say EMT anywhere on my patch.

> Now I offer a question for you: If a volunteer service in a rural

> town runs two calls a day and transports the patients to the ER,

> are they an EMS?

Yep.

> If a transfer service runs ten calls a day, and two of those calls

> are nursing home patients who are in bad shape and require

> immediate treatment and transport to the ER, are we not also

> performing emergency medical duties for this small NH " community " ?

Yep. But you still aren't EMS anymore than the bystander who

renders aid at an accident scene. Valuable? Yes. Professional?

Probably. EMS? Nope.

Rob

[Guest guest]

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

>

> I don't understand all this hostility towards transfer services

> Rob.

What hostility? I have no hostility for transfer services. None at

all. I just said they aren't Emergency Medical Services. I didn't

say that they suck or were doing the work of Satan. Where do you

get the hostility thing?

> We're all playing on the same field here... remove all of the the

> afflilations and types of service, and down deep inside, we're all

> EMTs.

As Mike so eloquently put it here in an earlier thread, it

doesn't say EMT anywhere on my patch.

> Now I offer a question for you: If a volunteer service in a rural

> town runs two calls a day and transports the patients to the ER,

> are they an EMS?

Yep.

> If a transfer service runs ten calls a day, and two of those calls

> are nursing home patients who are in bad shape and require

> immediate treatment and transport to the ER, are we not also

> performing emergency medical duties for this small NH " community " ?

Yep. But you still aren't EMS anymore than the bystander who

renders aid at an accident scene. Valuable? Yes. Professional?

Probably. EMS? Nope.

Rob

[Guest guest]

Wayne Edgin <ewedgin@y...> wrote:

>

> ...I still get up in the

> morning,proud as all get out,and put on my uniform and

> get after it.

Congratulations. You're a credit to the profession.

> You need to really think about what you

> have said here.

Okay, I've thought about it. I stand by it.

> There are other professions you might

> be suited for,maybe something where your question

> might be 'WOULD YOU LIKE FRIES WITH THAT??????????

Thanks for your concern, but I'll stick with nursing.

Rob

[Guest guest]

Wayne Edgin <ewedgin@y...> wrote:

>

> ...I still get up in the

> morning,proud as all get out,and put on my uniform and

> get after it.

Congratulations. You're a credit to the profession.

> You need to really think about what you

> have said here.

Okay, I've thought about it. I stand by it.

> There are other professions you might

> be suited for,maybe something where your question

> might be 'WOULD YOU LIKE FRIES WITH THAT??????????

Thanks for your concern, but I'll stick with nursing.

Rob

[Guest guest]

dustdevil31 wrote:

> What hostility? I have no hostility for transfer services.

You may not have said outright and in plain language, " transfer services suck " ,

but you might as well have. Are the prehospital NH patients we run on any less

important than the general, ambulatory population? You have offered this line

of service no respect for the prehospital responses we *do* manage on a daily

basis. You might as well have called us " glorified taxi drivers " ... that is the

impression you left. Go ahead, just say it and get it off your chest. I

doubt I am the only one that feels this way through your responses.

dustdevil31 wrote:

> But you still aren't EMS anymore than the bystander who renders aid at an

accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

1. The typical bystander at an accident scene does not have an MICU-equipped

ambulance at his disposal, nor knows how to use the items onboard.

2. The bystander does not have years of textbook and in-field training as any

state-certified EMT to properly care for the patient.

3. The bystander is not bound to treat the patient according to regional

medical protocols, which in my area is the same for all services... EMS,

volunteer, Fire, or private.

4. The bystander renders aid whether its appropriate or not, and the EMTs

render professional medical care because we ALL have been trained and educated

to do so. All of us.

There is simply no valid comparision between an EMT and a typical person on the

street. I am as capable of treating a trauma or medical problem as much as the

next EMT at my certification level. How can you tell us that a state licensed

EMS that offers transfer services is less capable, when they must hire the same

people... EMTs??? Transfer services must hire EMTs. EMS must hire EMTs.

Period. No exceptions.

dustdevil31 wrote:

> ... it doesn't say EMT anywhere on my patch.

Well, I must be special 'cause mine does ;-). Right there on the right sleeve

of my Class A shirt: " Texas Department of Health " . Then the state symbol

below, with the letters " EMT " in it. Then my certification level below that.

Seems I was required to sew that patch on as soon as I started working on an

ambulance... some sort of weird practice in this state about wearing your state

EMT patch on one sleeve, and the service patch on the other (sarcasm intended).

Interestingly enough, this is also the same for the local Fire/EMS here, the big

city EMS 50 miles away, another private service, and so on.

Unfortunately for this profession as a whole, I doubt your viewpoints will ever

change. My reason for responding to you in the first place was to address an

incorrect assumption. I'll respect the listowner's request to " drop it " if

asked. If no such request is made, then don't think that I'll allow you to

continue to degrade this line of work without basis on fact. You have your

opinion, and I have mine. But don't taint the *facts* with opinion.

You may be a licensed pilot who hasn't flown in years, but that is no

comparision for us in the transfer service. WE deal with EMS... yes, I said

" EMS " type responses daily, not once a year. Please don't belittle the medical

care we do render.

Kim

Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

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

>

> I don't understand all this hostility towards transfer services

> Rob.

What hostility? I have no hostility for transfer services. None at

all. I just said they aren't Emergency Medical Services. I didn't

say that they suck or were doing the work of Satan. Where do you

get the hostility thing?

> We're all playing on the same field here... remove all of the the

> afflilations and types of service, and down deep inside, we're all

> EMTs.

As Mike so eloquently put it here in an earlier thread, it

doesn't say EMT anywhere on my patch.

> Now I offer a question for you: If a volunteer service in a rural

> town runs two calls a day and transports the patients to the ER,

> are they an EMS?

Yep.

> If a transfer service runs ten calls a day, and two of those calls

> are nursing home patients who are in bad shape and require

> immediate treatment and transport to the ER, are we not also

> performing emergency medical duties for this small NH " community " ?

Yep. But you still aren't EMS anymore than the bystander who

renders aid at an accident scene. Valuable? Yes. Professional?

Probably. EMS? Nope.

Rob

[Guest guest]

dustdevil31 wrote:

> What hostility? I have no hostility for transfer services.

You may not have said outright and in plain language, " transfer services suck " ,

but you might as well have. Are the prehospital NH patients we run on any less

important than the general, ambulatory population? You have offered this line

of service no respect for the prehospital responses we *do* manage on a daily

basis. You might as well have called us " glorified taxi drivers " ... that is the

impression you left. Go ahead, just say it and get it off your chest. I

doubt I am the only one that feels this way through your responses.

dustdevil31 wrote:

> But you still aren't EMS anymore than the bystander who renders aid at an

accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

1. The typical bystander at an accident scene does not have an MICU-equipped

ambulance at his disposal, nor knows how to use the items onboard.

2. The bystander does not have years of textbook and in-field training as any

state-certified EMT to properly care for the patient.

3. The bystander is not bound to treat the patient according to regional

medical protocols, which in my area is the same for all services... EMS,

volunteer, Fire, or private.

4. The bystander renders aid whether its appropriate or not, and the EMTs

render professional medical care because we ALL have been trained and educated

to do so. All of us.

There is simply no valid comparision between an EMT and a typical person on the

street. I am as capable of treating a trauma or medical problem as much as the

next EMT at my certification level. How can you tell us that a state licensed

EMS that offers transfer services is less capable, when they must hire the same

people... EMTs??? Transfer services must hire EMTs. EMS must hire EMTs.

Period. No exceptions.

dustdevil31 wrote:

> ... it doesn't say EMT anywhere on my patch.

Well, I must be special 'cause mine does ;-). Right there on the right sleeve

of my Class A shirt: " Texas Department of Health " . Then the state symbol

below, with the letters " EMT " in it. Then my certification level below that.

Seems I was required to sew that patch on as soon as I started working on an

ambulance... some sort of weird practice in this state about wearing your state

EMT patch on one sleeve, and the service patch on the other (sarcasm intended).

Interestingly enough, this is also the same for the local Fire/EMS here, the big

city EMS 50 miles away, another private service, and so on.

Unfortunately for this profession as a whole, I doubt your viewpoints will ever

change. My reason for responding to you in the first place was to address an

incorrect assumption. I'll respect the listowner's request to " drop it " if

asked. If no such request is made, then don't think that I'll allow you to

continue to degrade this line of work without basis on fact. You have your

opinion, and I have mine. But don't taint the *facts* with opinion.

You may be a licensed pilot who hasn't flown in years, but that is no

comparision for us in the transfer service. WE deal with EMS... yes, I said

" EMS " type responses daily, not once a year. Please don't belittle the medical

care we do render.

Kim

Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

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

>

> I don't understand all this hostility towards transfer services

> Rob.

What hostility? I have no hostility for transfer services. None at

all. I just said they aren't Emergency Medical Services. I didn't

say that they suck or were doing the work of Satan. Where do you

get the hostility thing?

> We're all playing on the same field here... remove all of the the

> afflilations and types of service, and down deep inside, we're all

> EMTs.

As Mike so eloquently put it here in an earlier thread, it

doesn't say EMT anywhere on my patch.

> Now I offer a question for you: If a volunteer service in a rural

> town runs two calls a day and transports the patients to the ER,

> are they an EMS?

Yep.

> If a transfer service runs ten calls a day, and two of those calls

> are nursing home patients who are in bad shape and require

> immediate treatment and transport to the ER, are we not also

> performing emergency medical duties for this small NH " community " ?

Yep. But you still aren't EMS anymore than the bystander who

renders aid at an accident scene. Valuable? Yes. Professional?

Probably. EMS? Nope.

Rob

[Guest guest]

Say on Kim!!!!

Crosby

EMT-B

(I'll be damned, it even says Emergency Medical Technician on my patch too.

It's upside down, but it's really there... Gosh....)

Re: IRS looks into 2 ambulance firms for possible

> Medicare fraud

>

>

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

> >

> > I don't understand all this hostility towards transfer services

> > Rob.

>

> What hostility? I have no hostility for transfer services. None at

> all. I just said they aren't Emergency Medical Services. I didn't

> say that they suck or were doing the work of Satan. Where do you

> get the hostility thing?

>

> > We're all playing on the same field here... remove all of the the

> > afflilations and types of service, and down deep inside, we're all

> > EMTs.

>

> As Mike so eloquently put it here in an earlier thread, it

> doesn't say EMT anywhere on my patch.

>

> > Now I offer a question for you: If a volunteer service in a rural

> > town runs two calls a day and transports the patients to the ER,

> > are they an EMS?

>

> Yep.

>

> > If a transfer service runs ten calls a day, and two of those calls

> > are nursing home patients who are in bad shape and require

> > immediate treatment and transport to the ER, are we not also

> > performing emergency medical duties for this small NH " community " ?

>

> Yep. But you still aren't EMS anymore than the bystander who

> renders aid at an accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

>

> Rob

>

>

>

>

[Guest guest]

Say on Kim!!!!

Crosby

EMT-B

(I'll be damned, it even says Emergency Medical Technician on my patch too.

It's upside down, but it's really there... Gosh....)

Re: IRS looks into 2 ambulance firms for possible

> Medicare fraud

>

>

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

> >

> > I don't understand all this hostility towards transfer services

> > Rob.

>

> What hostility? I have no hostility for transfer services. None at

> all. I just said they aren't Emergency Medical Services. I didn't

> say that they suck or were doing the work of Satan. Where do you

> get the hostility thing?

>

> > We're all playing on the same field here... remove all of the the

> > afflilations and types of service, and down deep inside, we're all

> > EMTs.

>

> As Mike so eloquently put it here in an earlier thread, it

> doesn't say EMT anywhere on my patch.

>

> > Now I offer a question for you: If a volunteer service in a rural

> > town runs two calls a day and transports the patients to the ER,

> > are they an EMS?

>

> Yep.

>

> > If a transfer service runs ten calls a day, and two of those calls

> > are nursing home patients who are in bad shape and require

> > immediate treatment and transport to the ER, are we not also

> > performing emergency medical duties for this small NH " community " ?

>

> Yep. But you still aren't EMS anymore than the bystander who

> renders aid at an accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

>

> Rob

>

>

>

>

[Guest guest]

Before we start the turf wars again, let me say from personel experience that

the two providers named in this article are shady, and cast a very dim light on

those transport providers that do provide a good quality service, some of which

are in the DFW area.

In addition to the two named in the article, there were several more " shady "

operations that were hit the same day. DFW Ambulance, Royal, Care First, which

are in part connected with the first two.

We have all had dealings with " fly-by-night " providers. My question now is,

will TDH or DSHS do ANYTHING to pull these providers licensure? My guess, maybe

but probabaly not.

Wayne

Kim wrote:

dustdevil31 wrote:

> What hostility? I have no hostility for transfer services.

You may not have said outright and in plain language, " transfer services suck " ,

but you might as well have. Are the prehospital NH patients we run on any less

important than the general, ambulatory population? You have offered this line

of service no respect for the prehospital responses we *do* manage on a daily

basis. You might as well have called us " glorified taxi drivers " ... that is the

impression you left. Go ahead, just say it and get it off your chest. I

doubt I am the only one that feels this way through your responses.

dustdevil31 wrote:

> But you still aren't EMS anymore than the bystander who renders aid at an

accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

1. The typical bystander at an accident scene does not have an MICU-equipped

ambulance at his disposal, nor knows how to use the items onboard.

2. The bystander does not have years of textbook and in-field training as any

state-certified EMT to properly care for the patient.

3. The bystander is not bound to treat the patient according to regional

medical protocols, which in my area is the same for all services... EMS,

volunteer, Fire, or private.

4. The bystander renders aid whether its appropriate or not, and the EMTs

render professional medical care because we ALL have been trained and educated

to do so. All of us.

There is simply no valid comparision between an EMT and a typical person on the

street. I am as capable of treating a trauma or medical problem as much as the

next EMT at my certification level. How can you tell us that a state licensed

EMS that offers transfer services is less capable, when they must hire the same

people... EMTs??? Transfer services must hire EMTs. EMS must hire EMTs.

Period. No exceptions.

dustdevil31 wrote:

> ... it doesn't say EMT anywhere on my patch.

Well, I must be special 'cause mine does ;-). Right there on the right sleeve

of my Class A shirt: " Texas Department of Health " . Then the state symbol

below, with the letters " EMT " in it. Then my certification level below that.

Seems I was required to sew that patch on as soon as I started working on an

ambulance... some sort of weird practice in this state about wearing your state

EMT patch on one sleeve, and the service patch on the other (sarcasm intended).

Interestingly enough, this is also the same for the local Fire/EMS here, the big

city EMS 50 miles away, another private service, and so on.

Unfortunately for this profession as a whole, I doubt your viewpoints will ever

change. My reason for responding to you in the first place was to address an

incorrect assumption. I'll respect the listowner's request to " drop it " if

asked. If no such request is made, then don't think that I'll allow you to

continue to degrade this line of work without basis on fact. You have your

opinion, and I have mine. But don't taint the *facts* with opinion.

You may be a licensed pilot who hasn't flown in years, but that is no

comparision for us in the transfer service. WE deal with EMS... yes, I said

" EMS " type responses daily, not once a year. Please don't belittle the medical

care we do render.

Kim

Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

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

>

> I don't understand all this hostility towards transfer services

> Rob.

What hostility? I have no hostility for transfer services. None at

all. I just said they aren't Emergency Medical Services. I didn't

say that they suck or were doing the work of Satan. Where do you

get the hostility thing?

> We're all playing on the same field here... remove all of the the

> afflilations and types of service, and down deep inside, we're all

> EMTs.

As Mike so eloquently put it here in an earlier thread, it

doesn't say EMT anywhere on my patch.

> Now I offer a question for you: If a volunteer service in a rural

> town runs two calls a day and transports the patients to the ER,

> are they an EMS?

Yep.

> If a transfer service runs ten calls a day, and two of those calls

> are nursing home patients who are in bad shape and require

> immediate treatment and transport to the ER, are we not also

> performing emergency medical duties for this small NH " community " ?

Yep. But you still aren't EMS anymore than the bystander who

renders aid at an accident scene. Valuable? Yes. Professional?

Probably. EMS? Nope.

Rob

[Guest guest]

Yes, Wes they can be, especially the way that this entire deal went down and the

undercover investigation that took place.

ExLngHrn@... wrote: 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

[Guest guest]

Yes, Wes they can be, especially the way that this entire deal went down and the

undercover investigation that took place.

ExLngHrn@... wrote: 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

[Guest guest]

Yes, Wes they can be, especially the way that this entire deal went down and the

undercover investigation that took place.

ExLngHrn@... wrote: 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

[Guest guest]

Yes, , I think that it is called bi-polar disorder. I worked for this

guy while he was at Doctor's, and left because of this attitude and the fact

that we was giving kick backs to pt and fixing run sheets. He holds no EMS

certification either, but claimed to be an EMT.

Wayne

Hudson wrote:

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

[Guest guest]

Wayne,

TDSHS investigators can recommend fines and penalties to be levied against

the so called “fly by night” operations, but when it goes to a hearing,

which they have right to have most of the time the fines and penalties are

reduced. So if the investigator’s recommendation is for revocation of the

provider’s license and a $75,000 fine, that could be reduced to 12 months

probation and a $7000 fine for example. My point is that TDSHS has very

little power to put the so called “fly by nights” out of business. However

that doesn’t mean that the IRS or the State AG office cannot find violations

and lock up these offenders. I have an idea if you could find out, this

latest shady operation was under investigation by many agencies including

TDSHS.

I sure hope that all of these " fly by night " operations are sought out by

the IRS and other agencies and put out of business.

Bernie Stafford EMTP

________________________________________

From: [mailto: ] On

Behalf Of Wayne D

Sent: Friday, December 16, 2005 12:20 PM

To:

Subject: Re: Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

Before we start the turf wars again, let me say from personel experience

that the two providers named in this article are shady, and cast a very dim

light on those transport providers that do provide a good quality service,

some of which are in the DFW area.

  

  In addition to the two named in the article, there were several more

" shady " operations that were hit the same day.  DFW Ambulance, Royal, Care

First, which are in part connected with the first two.

  

  We have all had dealings with " fly-by-night " providers.  My question now

is, will TDH or DSHS do ANYTHING to pull these providers licensure?  My

guess, maybe but probabaly not. 

  

  Wayne

[Guest guest]

Wayne,

TDSHS investigators can recommend fines and penalties to be levied against

the so called “fly by night” operations, but when it goes to a hearing,

which they have right to have most of the time the fines and penalties are

reduced. So if the investigator’s recommendation is for revocation of the

provider’s license and a $75,000 fine, that could be reduced to 12 months

probation and a $7000 fine for example. My point is that TDSHS has very

little power to put the so called “fly by nights” out of business. However

that doesn’t mean that the IRS or the State AG office cannot find violations

and lock up these offenders. I have an idea if you could find out, this

latest shady operation was under investigation by many agencies including

TDSHS.

I sure hope that all of these " fly by night " operations are sought out by

the IRS and other agencies and put out of business.

Bernie Stafford EMTP

________________________________________

From: [mailto: ] On

Behalf Of Wayne D

Sent: Friday, December 16, 2005 12:20 PM

To:

Subject: Re: Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

Before we start the turf wars again, let me say from personel experience

that the two providers named in this article are shady, and cast a very dim

light on those transport providers that do provide a good quality service,

some of which are in the DFW area.

  

  In addition to the two named in the article, there were several more

" shady " operations that were hit the same day.  DFW Ambulance, Royal, Care

First, which are in part connected with the first two.

  

  We have all had dealings with " fly-by-night " providers.  My question now

is, will TDH or DSHS do ANYTHING to pull these providers licensure?  My

guess, maybe but probabaly not. 

  

  Wayne

[Guest guest]

Wayne,

TDSHS investigators can recommend fines and penalties to be levied against

the so called “fly by night” operations, but when it goes to a hearing,

which they have right to have most of the time the fines and penalties are

reduced. So if the investigator’s recommendation is for revocation of the

provider’s license and a $75,000 fine, that could be reduced to 12 months

probation and a $7000 fine for example. My point is that TDSHS has very

little power to put the so called “fly by nights” out of business. However

that doesn’t mean that the IRS or the State AG office cannot find violations

and lock up these offenders. I have an idea if you could find out, this

latest shady operation was under investigation by many agencies including

TDSHS.

I sure hope that all of these " fly by night " operations are sought out by

the IRS and other agencies and put out of business.

Bernie Stafford EMTP

________________________________________

From: [mailto: ] On

Behalf Of Wayne D

Sent: Friday, December 16, 2005 12:20 PM

To:

Subject: Re: Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

Before we start the turf wars again, let me say from personel experience

that the two providers named in this article are shady, and cast a very dim

light on those transport providers that do provide a good quality service,

some of which are in the DFW area.

  

  In addition to the two named in the article, there were several more

" shady " operations that were hit the same day.  DFW Ambulance, Royal, Care

First, which are in part connected with the first two.

  

  We have all had dealings with " fly-by-night " providers.  My question now

is, will TDH or DSHS do ANYTHING to pull these providers licensure?  My

guess, maybe but probabaly not. 

  

  Wayne

[Guest guest]

Okay, so here's a question: What would it take to get DSHS

investigators with teeth that were willing to enforce EMS regs?

Hell, I'm a cop. And a paramedic. And I'd jump at the chance to go

undercover and work for DSHS or the AG's office and be " Internal

Affairs " , going to work for these shady providers and documenting

everything I do, see and hear. I hate corruption, and I'd consider my

service valuable to those providers who do work to live up to and

exceed the standards, and weed out those who would rather cheat, lie

and steal to get " some " for themselves. There's several EMS certified

police officers I know who would jump at the chance to apply for an

Investigator slot at a state agency, especially if it involved a mix

of investigations and field work - so there's a very well trained

talent pool out there. What would it take to start getting the

positions created, funded, etc. for DSHS to actually step up

enforcement?

Mike

> Wayne,

>

> TDSHS investigators can recommend fines and penalties to be levied against

> the so called " fly by night " operations, but when it goes to a hearing,

> which they have right to have most of the time the fines and penalties are

> reduced. So if the investigator's recommendation is for revocation of the

> provider's license and a $75,000 fine, that could be reduced to 12 months

> probation and a $7000 fine for example. My point is that TDSHS has very

> little power to put the so called " fly by nights " out of business. However

> that doesn't mean that the IRS or the State AG office cannot find violations

> and lock up these offenders. I have an idea if you could find out, this

> latest shady operation was under investigation by many agencies including

> TDSHS.

> I sure hope that all of these " fly by night " operations are sought out by

> the IRS and other agencies and put out of business.

>

> Bernie Stafford EMTP

>

> ________________________________________

> From: [mailto: ] On

> Behalf Of Wayne D

> Sent: Friday, December 16, 2005 12:20 PM

> To:

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

> Medicare fraud

>

> Before we start the turf wars again, let me say from personel experience

> that the two providers named in this article are shady, and cast a very dim

> light on those transport providers that do provide a good quality service,

> some of which are in the DFW area.

>

> In addition to the two named in the article, there were several more

> " shady " operations that were hit the same day. DFW Ambulance, Royal, Care

> First, which are in part connected with the first two.

>

> We have all had dealings with " fly-by-night " providers. My question now

> is, will TDH or DSHS do ANYTHING to pull these providers licensure? My

> guess, maybe but probabaly not.

>

> Wayne

>

>

>

>

>

>

>

>

[Guest guest]

Okay, so here's a question: What would it take to get DSHS

investigators with teeth that were willing to enforce EMS regs?

Hell, I'm a cop. And a paramedic. And I'd jump at the chance to go

undercover and work for DSHS or the AG's office and be " Internal

Affairs " , going to work for these shady providers and documenting

everything I do, see and hear. I hate corruption, and I'd consider my

service valuable to those providers who do work to live up to and

exceed the standards, and weed out those who would rather cheat, lie

and steal to get " some " for themselves. There's several EMS certified

police officers I know who would jump at the chance to apply for an

Investigator slot at a state agency, especially if it involved a mix

of investigations and field work - so there's a very well trained

talent pool out there. What would it take to start getting the

positions created, funded, etc. for DSHS to actually step up

enforcement?

Mike

> Wayne,

>

> TDSHS investigators can recommend fines and penalties to be levied against

> the so called " fly by night " operations, but when it goes to a hearing,

> which they have right to have most of the time the fines and penalties are

> reduced. So if the investigator's recommendation is for revocation of the

> provider's license and a $75,000 fine, that could be reduced to 12 months

> probation and a $7000 fine for example. My point is that TDSHS has very

> little power to put the so called " fly by nights " out of business. However

> that doesn't mean that the IRS or the State AG office cannot find violations

> and lock up these offenders. I have an idea if you could find out, this

> latest shady operation was under investigation by many agencies including

> TDSHS.

> I sure hope that all of these " fly by night " operations are sought out by

> the IRS and other agencies and put out of business.

>

> Bernie Stafford EMTP

>

> ________________________________________

> From: [mailto: ] On

> Behalf Of Wayne D

> Sent: Friday, December 16, 2005 12:20 PM

> To:

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

> Medicare fraud

>

> Before we start the turf wars again, let me say from personel experience

> that the two providers named in this article are shady, and cast a very dim

> light on those transport providers that do provide a good quality service,

> some of which are in the DFW area.

>

> In addition to the two named in the article, there were several more

> " shady " operations that were hit the same day. DFW Ambulance, Royal, Care

> First, which are in part connected with the first two.

>

> We have all had dealings with " fly-by-night " providers. My question now

> is, will TDH or DSHS do ANYTHING to pull these providers licensure? My

> guess, maybe but probabaly not.

>

> Wayne

>

>

>

>

>

>

>

>

[Guest guest]

Okay, so here's a question: What would it take to get DSHS

investigators with teeth that were willing to enforce EMS regs?

Hell, I'm a cop. And a paramedic. And I'd jump at the chance to go

undercover and work for DSHS or the AG's office and be " Internal

Affairs " , going to work for these shady providers and documenting

everything I do, see and hear. I hate corruption, and I'd consider my

service valuable to those providers who do work to live up to and

exceed the standards, and weed out those who would rather cheat, lie

and steal to get " some " for themselves. There's several EMS certified

police officers I know who would jump at the chance to apply for an

Investigator slot at a state agency, especially if it involved a mix

of investigations and field work - so there's a very well trained

talent pool out there. What would it take to start getting the

positions created, funded, etc. for DSHS to actually step up

enforcement?

Mike

> Wayne,

>

> TDSHS investigators can recommend fines and penalties to be levied against

> the so called " fly by night " operations, but when it goes to a hearing,

> which they have right to have most of the time the fines and penalties are

> reduced. So if the investigator's recommendation is for revocation of the

> provider's license and a $75,000 fine, that could be reduced to 12 months

> probation and a $7000 fine for example. My point is that TDSHS has very

> little power to put the so called " fly by nights " out of business. However

> that doesn't mean that the IRS or the State AG office cannot find violations

> and lock up these offenders. I have an idea if you could find out, this

> latest shady operation was under investigation by many agencies including

> TDSHS.

> I sure hope that all of these " fly by night " operations are sought out by

> the IRS and other agencies and put out of business.

>

> Bernie Stafford EMTP

>

> ________________________________________

> From: [mailto: ] On

> Behalf Of Wayne D

> Sent: Friday, December 16, 2005 12:20 PM

> To:

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

> Medicare fraud

>

> Before we start the turf wars again, let me say from personel experience

> that the two providers named in this article are shady, and cast a very dim

> light on those transport providers that do provide a good quality service,

> some of which are in the DFW area.

>

> In addition to the two named in the article, there were several more

> " shady " operations that were hit the same day. DFW Ambulance, Royal, Care

> First, which are in part connected with the first two.

>

> We have all had dealings with " fly-by-night " providers. My question now

> is, will TDH or DSHS do ANYTHING to pull these providers licensure? My

> guess, maybe but probabaly not.

>

> Wayne

>

>

>

>

>

>

>

>

[Guest guest]

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

> >

> > I don't understand all this hostility towards transfer services

> > Rob.

>

> What hostility? I have no hostility for transfer services. None at

> all. I just said they aren't Emergency Medical Services. I didn't

> say that they suck or were doing the work of Satan. Where do you

> get the hostility thing?

M> I think that Rob is trying, subtly at times, to draw a line in

the sand between " EMERGENCY " medical services providers - those that

respond to EMERGENCY calls as defined by activation of the 911 system,

vs. those that deal with patients who already have medical care

available to them, but need transfer to more or different care.

I agree with his distinction, but not with the tack he's taking to get

to the point. I worked for a very, very good 911 service that served

a primarily rural area. We had a 4-bed ER with a doctor on-call after

hours and were roughly 1 hour from a trauma center by ground in good

weather. We ran one paid truck full time, and had one

paid/volunteer/on-call truck in reserve. We had mutual aid agreements

for extra coverage, and provided mutual aid when needed. We also

handled transfers from our local hospital (we were not hospital based,

per-se, but had an affiliation with the facility) to higher levels of

care when the transfer was for an acute problem - otherwise, the

transfer was handled by a non-emergency transfer service. We had

fantastic protocols, lots of equipment, and the training to use it.

We even got to practice up to our skill level in the ER when we

brought in a patient, often " prepping " for what the doc would do when

he arrived, drawing labs, cleaning for sutures, minor surgery, etc.

And we'd transport to the local facility for stabilization, then do

the emergency transfer to definitive care 15-30 minutes later. We ran

transfers, but they were a direct result of an emergency condition

that exceeded the capabilities of the local medical staff, and all

were due to acute conditions.

I think Rob is trying to draw a distinction between emergency and

acute care vs. dealing with patients who need medical care for chronic

conditions and are already in a long-term-care environment.

I know that in Austin, Austin EMS licenses transfer services

(franchise licenses) to initiate transfers in the city limits. There

are guidelines such that if a transfer services accepts a transfer,

then finds the patient is more acute, the transfer service must notify

Austin EMS and possibly relinquish the patient to them for treatment

and transport. They, like Rob, draw a line between providing

transport as a primary treatment, and providing treatment prior to

transport.

> > We're all playing on the same field here... remove all of the the

> > afflilations and types of service, and down deep inside, we're all

> > EMTs.

>

> As Mike so eloquently put it here in an earlier thread, it

> doesn't say EMT anywhere on my patch.

M> Correct. The LP patch does not say EMT on it. Also, you are

not required, as alluded elsewhere, to even wear a patch - just to

identify the level of care you provide. Simply wearing a name tag

with your service name, your name and " Paramedic " would be appropriate

identification for any EMT-P or LP - or they can wear their respective

patches. Either way, the LP patch and certification card no longer

says EMT. It's been argued that this amounts to semantics, and I have

my beliefs on this, but that's another whole re-hash of an arguement.

> Yep. But you still aren't EMS anymore than the bystander who

> renders aid at an accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

M> Okay, Rob, here's a question. What about first responders?

Are they EMS? What, in your exact definition, meets the " E "

requirement of EMS?

Mike

[Guest guest]

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

> >

> > I don't understand all this hostility towards transfer services

> > Rob.

>

> What hostility? I have no hostility for transfer services. None at

> all. I just said they aren't Emergency Medical Services. I didn't

> say that they suck or were doing the work of Satan. Where do you

> get the hostility thing?

M> I think that Rob is trying, subtly at times, to draw a line in

the sand between " EMERGENCY " medical services providers - those that

respond to EMERGENCY calls as defined by activation of the 911 system,

vs. those that deal with patients who already have medical care

available to them, but need transfer to more or different care.

I agree with his distinction, but not with the tack he's taking to get

to the point. I worked for a very, very good 911 service that served

a primarily rural area. We had a 4-bed ER with a doctor on-call after

hours and were roughly 1 hour from a trauma center by ground in good

weather. We ran one paid truck full time, and had one

paid/volunteer/on-call truck in reserve. We had mutual aid agreements

for extra coverage, and provided mutual aid when needed. We also

handled transfers from our local hospital (we were not hospital based,

per-se, but had an affiliation with the facility) to higher levels of

care when the transfer was for an acute problem - otherwise, the

transfer was handled by a non-emergency transfer service. We had

fantastic protocols, lots of equipment, and the training to use it.

We even got to practice up to our skill level in the ER when we

brought in a patient, often " prepping " for what the doc would do when

he arrived, drawing labs, cleaning for sutures, minor surgery, etc.

And we'd transport to the local facility for stabilization, then do

the emergency transfer to definitive care 15-30 minutes later. We ran

transfers, but they were a direct result of an emergency condition

that exceeded the capabilities of the local medical staff, and all

were due to acute conditions.

I think Rob is trying to draw a distinction between emergency and

acute care vs. dealing with patients who need medical care for chronic

conditions and are already in a long-term-care environment.

I know that in Austin, Austin EMS licenses transfer services

(franchise licenses) to initiate transfers in the city limits. There

are guidelines such that if a transfer services accepts a transfer,

then finds the patient is more acute, the transfer service must notify

Austin EMS and possibly relinquish the patient to them for treatment

and transport. They, like Rob, draw a line between providing

transport as a primary treatment, and providing treatment prior to

transport.

> > We're all playing on the same field here... remove all of the the

> > afflilations and types of service, and down deep inside, we're all

> > EMTs.

>

> As Mike so eloquently put it here in an earlier thread, it

> doesn't say EMT anywhere on my patch.

M> Correct. The LP patch does not say EMT on it. Also, you are

not required, as alluded elsewhere, to even wear a patch - just to

identify the level of care you provide. Simply wearing a name tag

with your service name, your name and " Paramedic " would be appropriate

identification for any EMT-P or LP - or they can wear their respective

patches. Either way, the LP patch and certification card no longer

says EMT. It's been argued that this amounts to semantics, and I have

my beliefs on this, but that's another whole re-hash of an arguement.

> Yep. But you still aren't EMS anymore than the bystander who

> renders aid at an accident scene. Valuable? Yes. Professional?

> Probably. EMS? Nope.

M> Okay, Rob, here's a question. What about first responders?

Are they EMS? What, in your exact definition, meets the " E "

requirement of EMS?

Mike

[Guest guest]

" Undercover " ...are you serious? How many undercover people does DSHS

or JCAHO put into hospitals? How many undercover police work for the

Texas Fire Commission sneaking into FD's to spy on them? What about

the BME...cop-doctors " hiring " onto practices so they can " catch " bad

doctors doing things wrong....

I sense a new TV show....undercover EMT....their cops, their

ditch-doctors...their ticket writin' life savers....

" Tonight on Undercover EMT...'Hey man, my wife isn't

breathing'...{undercover EMT}'Yeah man...I'll get to her..but I have to

finish this ticket to my partner because he went 11 mph over the speed

limit and our SOP's mandate 10'.... "

Re: Re: IRS looks into 2 ambulance firms for

possible

> Medicare fraud

>

> Before we start the turf wars again, let me say from personel

experience

> that the two providers named in this article are shady, and cast a

very dim

> light on those transport providers that do provide a good quality

service,

> some of which are in the DFW area.

>

> In addition to the two named in the article, there were several more

> " shady " operations that were hit the same day. DFW Ambulance, Royal,

Care

> First, which are in part connected with the first two.

>

> We have all had dealings with " fly-by-night " providers. My question

now

> is, will TDH or DSHS do ANYTHING to pull these providers licensure? My

> guess, maybe but probabaly not.

>

> Wayne

>

>

>

>

>

>

>

>

[Guest guest]

Consider it. If you have a provider that you need more evidence on,

why not put a paramedic in there who can gather the evidence, but do

so in a manner that meets the legal requirements for evidence

gathering, and can then testify from both sides of the fence?

Undercover operatives are used frequently in drug and organized crime

scenarios in many major police and investigative organizations. We're

not talking " Bond " kind of stuff here - just paramedics who are

also investigators, doing a paramedic job at these copmanies suspected

of committing fraud. It would save the ones that aren't from a public

investigation, and help more firmly convict those that are involved.

Mike

> " Undercover " ...are you serious? How many undercover people does DSHS

> or JCAHO put into hospitals? How many undercover police work for the

> Texas Fire Commission sneaking into FD's to spy on them? What about

> the BME...cop-doctors " hiring " onto practices so they can " catch " bad

> doctors doing things wrong....

>

> I sense a new TV show....undercover EMT....their cops, their

> ditch-doctors...their ticket writin' life savers....

>

> " Tonight on Undercover EMT...'Hey man, my wife isn't

> breathing'...{undercover EMT}'Yeah man...I'll get to her..but I have to

> finish this ticket to my partner because he went 11 mph over the speed

> limit and our SOP's mandate 10'.... "

>

>

>

> Re: Re: IRS looks into 2 ambulance firms for

> possible

> > Medicare fraud

> >

> > Before we start the turf wars again, let me say from personel

> experience

> > that the two providers named in this article are shady, and cast a

> very dim

> > light on those transport providers that do provide a good quality

> service,

> > some of which are in the DFW area.

> >

> > In addition to the two named in the article, there were several more

> > " shady " operations that were hit the same day. DFW Ambulance, Royal,

> Care

> > First, which are in part connected with the first two.

> >

> > We have all had dealings with " fly-by-night " providers. My question

> now

> > is, will TDH or DSHS do ANYTHING to pull these providers licensure? My

> > guess, maybe but probabaly not.

> >

> > Wayne

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

EMS

Ambulance Transport

Drug and Organized Crime Scenarios...

Yeah...I see the tie.

Dudley

Re: Re: IRS looks into 2 ambulance firms for

> possible

> > Medicare fraud

> >

> > Before we start the turf wars again, let me say from personel

> experience

> > that the two providers named in this article are shady, and cast a

> very dim

> > light on those transport providers that do provide a good quality

> service,

> > some of which are in the DFW area.

> >

> > In addition to the two named in the article, there were several

more

> > " shady " operations that were hit the same day. DFW Ambulance, Royal,

> Care

> > First, which are in part connected with the first two.

> >

> > We have all had dealings with " fly-by-night " providers. My question

> now

> > is, will TDH or DSHS do ANYTHING to pull these providers licensure?

My

> > guess, maybe but probabaly not.

> >

> > Wayne

> >

> >

> >

> >

> >

> >

> >

> >

[Guest guest]

Man Rob,

I have seen you beat this horse for some time...and after reading this

one...I am really concerned. Are you that big of a woo woo to actually

think that EMS is only Emergency? Scene=Emergency? I know of a lot

sicker patients " transferred " by " non-EMS " agencies than the patients

our " EMS " agency transports...

What about all these " EMS " agencies that also do the lowly

transfers...what are they? Do they need magnetic stickers for their

" vehicles " so that they can have " Taxi " on when they are transferring

patients and stop and stick on the " EMS " sticker when they answer a 911

call?

BTW, what makes the hip fracture in the nursing home less important (or

need less care) than the hip fracture in a living room?

Dudley

Re: IRS looks into 2 ambulance firms for possible

Medicare fraud

" simple_emt " <simple_emt@y...> wrote:

>

> 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).

I think I understand where your screen name comes from. And I am

sorry that the concept is not simple enough for you. However, we

are not talking about standards. We are talking about services

rendered. So here it is as simple as it can be put. If you are a

pilot, who never flies, you are not flying. If you are a painter

who never paints, you are not painting. And if you are licensed as

an " EMS provider " but are not rendering EMERGENCY MEDICAL SERVICES,

you are not in EMS. You're just holding the license.

Don't like that? Sorry. If you are uncomfortable with it, get a

job in EMS.

Rob