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  • Tuesday, September 30, 2014 9:16 AM | PAAW Administrator (Administrator)

    Two former Sullivan Emergency Medical Service members charged with theft and misconduct in public office were released on $10,000 signature bonds on Tuesday, September 16.


    Kimberly Heine and Richard Heine, of Helenville, the former deputy chief and chief of Sullivan EMS, respectively, are accused of fraudulent actions relating to funds and property associated with the former emergency medical service.


    The couple appeared before Jefferson County Circuit Court Judge Jennifer Weston to face the charges, including one count each of theft-false representation over $10,000 and misconduct in office-fraudulent records/statement. In addition, Kimberly Heine is charged with one count of identity theft for financial gain.


    If convicted, Kimberly Heine faces a combined maximum sentence of 19 1/2 years in prison and fines of more than $45,000, while Richard Heine could be sentenced to a maximum of 13 1/2 years in prison and fines totaling more than $35,000.  A pre-trial conference at the District Attorney’s Office was scheduled for Wednesday, Oct. 15.

    The Heines are not to work for any ambulance or EMS service, but were granted permission to continue operating their medical transportation business called Sullivan Prestige Ambulance Inc. or Prestige Transports, as long as they only are paid directly by the users of that service and not handling the clients’ accounts. As ordered, they are not to engage in any business in which they are entrusted with someone else’s money.


    According to the criminal complaint, the theft and misconduct in office offenses allegedly committed by the pair occurred between January 2011 and June 30, 2012. The single count of identity theft for financial gain charged against Kimberly Heine relates to her alleged use of the Sullivan EMS phone number from July 3, 2012, to August 20, 2012.


    The Jefferson County Sheriff’s Office was contacted by the Sullivan EMS Secretary/Treasurer Nancy Emons about the service’s telephone number being disconnected and ported to a personal U.S. Cellular account in the name of Kimberly Heine in August 2012.


    The couple had been suspended from their duties within Sullivan EMS on June 23, 2012, pending the outcome of an internal investigation and audit. The suspension had been the result of allegations that the pair had mismanaged funds and assets at Sullivan EMS as chief (Richard) and deputy chief (Kimberly) and administrative assistant.


    Kimberly Heine did all the recordkeeping as part of her duties as administrative assistant, including payroll.

    The Sullivan EMS Board of Directors voted to terminate the couple’s employment on July 3, 2012, and on July 9, Emons reportedly contacted the telephone company asking it to remove the pair as authorized persons on the account, the complaint said.


    The board believed Heine was attempting to start her own emergency transport company using the Sullivan EMS telephone number.


    Kimberly Heine admitted to authorities of taking possession of the phone number “due to the fact that Sullivan EMS had abandoned the number.”


    According to the complaint, she said members of Sullivan EMS had asked her to find a way to cut the phone bill and that they were aware that the phone number in question would be cancelled to reduce the bill.


    Emons reportedly countered that a conversation about reducing the phone bill was held; however, “cancelling the main phone line was never an option.”

    Kimberly also allegedly admitted in an interview with detectives that her new transport company, Sullivan Prestige Ambulance, was providing inter-facility transportation, which Sullivan EMS no longer provided, and that people contacting her at the stolen Sullivan EMS number for this service could get it through her company, the complaint said.


    Under Federal Communications Commission requirements, a tax identification number was required for control of the phone number.


    Kimberly stated that a U.S. Cellular employee provided the tax identification number, but she admitted that she and her husband had access to the Sullivan EMS tax identification number because it was stored in their home, according to the complaint.


    The mentioned U.S. Cellular employee denied providing the tax identification number, stating in the complaint that he only had access to the last four digits of the number.


    Even after the number had been returned to Sullivan EMS, investigators attempted to contact Kimberly using a phone number she provided and in reaching her voicemail found she was still representing herself as being affiliated with Sullivan EMS.


    Further investigation related to the Heines’ alleged illegal runs by Sullivan EMS that were not reported to LifeQuest, the processor for Sullivan EMS.


    Kami Warren, former Sullivan EMS chief, provided documentation which details a total of 533.25 runs Kimberly submitted to Sullivan EMS payroll, but not to LifeQuest. By statute, all runs by Sullivan EMS had to be reported to LifeQuest.


    According to the complaint, Warren’s documentation also showed 499 runs reported by Richard Heine to Sullivan EMS, but not to LifeQuest.


    Reports show that Sullivan EMS overpaid Kimberly Heine $13,647.50 for runs and Richard by $13,514.75.


    It was further noted that “at no time was Kimberly approved to receive $1,250 per month as a regular monthly stipend.”


    Kimberly was appointed as both deputy chief of inter-facility and administrative assistant beginning Sept. 1, 2011, with a total monthly stipend of $700.

    Payroll summaries in the complaint show that Kimberly received a stipend in excess of $17,503 from January 2011 to June 2012.


    When confronted with the allegations, the Heines defended the unaccounted-for runs, citing that LifeQuest would deny runs because they were not medically necessary or that runs were not billed because they were submitted through the Sentimental Journeys program.


    The couple also said runs would go unreported if they lasted more than two hours, the complaint said.


    Source:  Ryan Whisner, Daily Union regional editor

  • Thursday, September 18, 2014 12:24 PM | PAAW Administrator (Administrator)
    On September 17, Jack Hill, executive director at Gold Cross Ambulance Service, headquartered in Menasha, was named 2014 Wisconsin Honorary Star of Life and Lifetime Member of the Professional Ambulance Association of Wisconsin. 

     

    The award was presented by the Professional Ambulance Association of Wisconsin where Hill is treasurer and serves on the board of directors.  Governor Scott Walker acknowledged the moment by providing Hill with a certificate of appreciation for his many years of service to citizens of Wisconsin.  The award presentation and recognition dinner was held at Tundra Lodge in Green Bay during the annual Paramedic Systems of Wisconsin Conference.  Several Gold Cross Ambulance employees, pictured with Hill, attended the program to celebrate the occasion.

     

    During his 21 years of leadership, Gold Cross has grown from 60 employees to more than 160, and from 8 ambulances to 17. The company has incorporated new technologies and clinical care protocols while he’s been at the helm, and has expanded to become a regional service covering 1,200 square miles of Outagamie, Winnebago, Calumet and Waupaca counties, serving more than 260,000 people.

     

    As a part-time police officer in mid-1976 in his home town of Hoyt Lakes, MN, Hill got a taste of the career that would eventually become his passion.  He was hired at Gold Cross in 1985 as a paramedic, when he decided to turn his volunteer EMS work into a career. Today, looking back over 29 years with Gold Cross, he remains committed to the quality, efficiency, dedication, compassion and professionalism that characterize the company and his life.

     

    In early 2015, Jack and Noi Hill will live part-time in Thailand, spending time with family, enjoying a life of retirement and new adventures.


    (Picture insert, left to right, Professional Ambulance Association of Wisconsin President Patrick Ryan, Jack Hill, Noi Hill)

  • Tuesday, September 16, 2014 12:45 PM | PAAW Administrator (Administrator)

    WASHINGTONundefinedThe general manager of a Southern California ambulance company pleaded guilty yesterday in Los Angeles to conspiracy to commit Medicare fraud, conspiracy to obstruct a Medicare audit, and making materially false statements to law enforcement officers.


    Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, Acting U.S. Attorney Stephanie Yonekura of the Central District of California, Special Agent in Charge Glenn R. Ferry of the Los Angeles Region of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) and Assistant Director in Charge Bill Lewis of the FBI’s Los Angeles Field Office made the announcement.


    Wesley Harlan Kingsbury, 34, of Bloomington, California, pleaded guilty to the charges before U.S. District Judge Dale S. Fischer. Sentencing is scheduled for Feb. 9, 2015.


    According to court documents, Kingsbury was the general manager of Alpha Ambulance Inc., which specialized in the provision of non-emergency ambulance transportation services to Medicare beneficiaries, primarily to and from dialysis treatments. Between April 2010 and July 2012, Kingsbury conspired with Alex Kapri and Aleksey (Russ) Muratov, the owners of Alpha Ambulance, as well as the training supervisor Danielle Medina, to bill Medicare for ambulance transportation services for individuals that Kingsbury knew did not need to be transported by ambulance. In addition, as general manager, Kingsbury instructed emergency medical technicians (EMTs) that worked at Alpha Ambulance to conceal the true medical condition of patients they were transporting by altering requisite paperwork and creating false reasons to justify the transportation services.


    In early 2012, Medicare notified Alpha Ambulance that the company would be subject to a Medicare audit. In response, Kingsbury and his co-conspirators altered patient documentation to create false justifications for the ambulance transportation services. Kingsbury and others used light tracing tables to trace over original documents and create falsified patient documentation for the purpose of sending those falsified documents to Medicare, and then they used a paper shredder to destroy the original patient documents.


    Kingsbury and his co-conspirators submitted $5,522,079 in fraudulent claims to Medicare, and Medicare paid $1,338,413 on those fraudulent claims.


    Further according to court documents, in April 2012, Kingsbury was approached by law enforcement officers and was asked to assist with the investigation into Alpha Ambulance. Kingsbury disclosed to the owners of Alpha Ambulance the names of the law enforcement officers who were conducting the investigation and the questions they had asked Kingsbury about the company. On May 1, 2012, Kingsbury falsely denied to the law enforcement agents that he had previously disclosed that information to the owners of Alpha.


    Kapri, Muratov and Medina pleaded guilty to conspiracy to commit health care fraud on October 28, 2013. They were sentenced to terms of imprisonment of 75 months, 108 months, and 30 months, respectively.


    The case was investigated by the FBI and the Los Angeles Region of HHS-OIG and was brought as part of the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Central District of California. The case was prosecuted by Trial Attorneys Blanca Quintero and Alexander F. Porter and Assistant Chief Ben Curtis of the Criminal Division’s Fraud Section.


    Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,000 defendants who have collectively billed the Medicare program for more than $6 billion. In addition, the HHS Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

  • Monday, September 15, 2014 10:08 AM | PAAW Administrator (Administrator)
    Medicare reimbursement rates will increase by 1.4% for ambulance services in 2015, but that's not the whole story.  CMS is also proposing to change designations of certain zip codes from rural to urban and vice-versa in 2015, and this would affect reimbursement amounts to ambulance providers picking up in those zip codes.  Moreover, unless Congress passes legislation, the urban, rural and super-rural ambulance bonus payments will expire on March 31, 2015. There are a lot of big things set to impact ambulance reimbursement in the coming year.


    Source:  Page, Wolfberg and Wirth EMS Attorneys

  • Wednesday, July 23, 2014 7:02 AM | PAAW Administrator (Administrator)
    By David M. Werfel, Attorney, American Ambulance Association


    When the patient is unable to sign the form requesting payment and authorizing the release of records due to a physical or mental condition, the request may be executed on their behalf by a legal guardian, relative, representative payee or representative of an institution providing care.
     
    Until now, the person signing on behalf of the patient was required to also list their name, address, relationship to the patient and reason the patient could not sign.


    Over two years ago, I asked CMS to remove the requirement of the address, when one of the Medicare Administrative Contractors (WPS) notified ambulance suppliers the address was required.  The requirement of the address of the person signing on behalf of the patient was impractical as there was no space on the 1500 form for it, no field for it on electronic claims, it was not required in the CMS Regulation (42 C.F.R. 424.36) and the industry would usually not be able to obtain it.

    After many follow-ups, CMS has removed the requirement in Transmittal 2984.

    Link to transmittal: 
    https://www.cms.gov/ Regulations-and-Guidance/ Guidance/Transmittals/ Downloads/R2984CP.pdf

    In sum, the address of the person signing on behalf of the patient is no longer needed.

  • Tuesday, June 24, 2014 9:17 PM | PAAW Administrator (Administrator)
    The Professional Ambulance Association of Wisconsin Board of Directors is pleased to announce they have recently appointed attorney Thomas Shorter as their consultant on health care matters, to include the Affordable Care Act.  Mr. Shorter is with the firm Godfrey & Kahn in Madison. 

     

    According to PAAW President Patrick Ryan, “Mr. Shorter is highly regarded for his health care knowledge and awareness to ACA.  We look forward to his expertise as we anticipate many questions about ACA and navigating it both as healthcare providers and as EMS employers.  Having this relationship in place will help the Association, its members and other ambulance services that need a resource to consult.”

     

    Mr. Shorter added, “We greatly value our new relationship with PAAW.  Under the Affordable Care Act (ACA) the United States is rapidly moving towards more alignment of all health care providers, both clinically and economically.  Ambulance service providers are a critical element of the system, and often the entry-point into the system.  Our expertise in health care and corporate law allows us to partner with PAAW and its members to address the legal issues in the evolving healthcare landscape.  We look forward to a long and relationship with PAAW.”

     

    Mr. Shorter was also recently appointed to the Board of Directors for the American Health Lawyers Association, which is the largest national health law association in the US.

  • Monday, June 23, 2014 7:25 PM | PAAW Administrator (Administrator)
    The Wisconsin Department of Health Services has posted the job search announcement for the state EMS Director position.


    The Emergency Medical Services (EMS) Director is responsible for managing and directing the EMS Unit staff and its programs. The EMS Director assigns, directs, and supervises projects specific or related to emergency medical services.

     

    Responsibilities of this position include leadership, management, and coordination of a complex EMS system across the state, involving federal, state, and local governments, local service providers, hospitals, other public safety organizations, and elements from the private sector, for quality emergency medical care for all Wisconsin citizens and visitors. The EMS Director leads the enforcement activities of all EMS providers regulated by the EMS program and recommends licensure/certification for EMS providers to assure the provision of quality emergency medical services in Wisconsin. This position manages the Unit’s EMS data collection and processing operations, as well as internal quality assurance programs.

     

    Salary is negotiable based on qualifications and will be between $22.470 and $37.076 per hour (approx $46,917 and $77,414 per year).  The application deadline is July 7, 2014.

     

    For more information or to apply, click here.

  • Monday, June 23, 2014 7:15 PM | PAAW Administrator (Administrator)
    All current Wisconsin EMS provider licenses and certifications expire on June 30, 2014, unless you have recently renewed or been issued.


    The mission of the Wisconsin Emergency Medical Services (EMS) program is to ensure that the highest quality and standards of pre-hospital emergency medical care are available to all Wisconsin citizens and visitors. Certification or licensing provides a level of protection to Wisconsin citizens and visitors, and assures that an individual holding a certificate or license has met certain minimum competencies and is authorized to practice, as defined by law. All current Wisconsin EMS provider licenses and certifications expire on June 30, 2014.


    Besides holding a current Wisconsin certification and license to practice as an Emergency Medical Services provider in Wisconsin, you must also be locally credentialed with the service for which you are practicing. Licenses and certifications must be renewed prior to the expiration date of June 30, 2014, in order to continue practicing under your license. To practice as an EMT or First Responder in Wisconsin, you must have a current license/certificate and be credentialed with a service.


    The 2014-2016, Provider License Renewal application is available online through  E-Licensing account for the July 1, 2014, through June 30, 2016, licensing biennium. You must complete the 2014-2016, Provider Renewal application by June 30, 2014, in order to obtain a current certification or license that is valid until June 30, 2016.


    All Wisconsin EMS provider applications are completed in the E-Licensing system. The important renewal dates to remember for 2014-2016, are:


    • November 1, 2013 through June 30, 2014 is the standard renewal period.
    • July 1, 2014 through December 31, 2014 is the late renewals period and incurs a $50 late renewal administrative fee (per DHS 110.16 (1) (a)).


    For more information or to review the long version of this information, click here.
  • Tuesday, June 03, 2014 11:30 PM | PAAW Administrator (Administrator)

    PAAW leadership to meet with DHS officials


    In the next few weeks, the Professional Ambulance Association of Wisconsin will be meeting with officials at the Wisconsin Department of Health Services. 

     

    According to PAAW President Patrick Ryan, “Questions and concerns have been raised in light of recent changes at the State’s EMS Office and its future direction.  We felt now was an appropriate time to contact DHS and have this important conversation, which they scheduled a time with us shortly after the letter was sent.”  He added, “We’ve had productive conversations in the past with officials at DHS and feel we will again.”

     

    The letter sent to DHS identified three areas PAAW would like to discuss, to include:

    1. What are the short and long term plans for the Office and how will the industry’s needs be met?
    2. What is the status of the most recent NHTSA review?  Discussion on the study has seemingly been non-existent.
    3. Concerns with the reduction in Funding Assistance Program (FAP) funds available to state providers.
    As an EMS stakeholder, PAAW is committed to insuring the strength and vitality of EMS in Wisconsin through representation of its members and EMS at-large.
  • Tuesday, May 27, 2014 8:47 PM | PAAW Administrator (Administrator)

    By Melissa M. Trumbull, Industry Relations Manager, NAEMT

     

    On Thursday, May 22, the U.S. Senate, led by Sen. Michael Bennet (D-Colo.), Sen. Mike Crapo (R-Idaho) and Sen. Tim Johnson (D-S.D) honored our nation’s EMS practitioners during EMS Week by introducing the S.2400 Field EMS Innovation Act (Field EMS Bill) in the Senate. This bill is the companion to the Field EMS Bill introduced in the U.S. House of Representatives on February 26, 2013, as H.R. 809 by Congressman Larry Bucshon (R-Ind.).

     

    The Field EMS Bill addresses many of the challenges EMS systems face while trying to fulfill public expectations that all who need EMS can depend upon the highest quality of care and transport to the most appropriate clinical setting. This is the first bill to seriously look at EMS issues since the 1960s, the act would improve access to essential and life-saving EMS services and better integrate EMS within the larger health care system. Regardless of the model of EMS care delivery – whether governmental, nonprofit, private or volunteer – all EMS providers fulfill an essential public function for all patients in need. This function is carried out to the best of their ability and in spite of limited resources. The Field EMS Bill puts patients first by promoting high quality and evidence-based care for all patients in need of emergency medical care.

     

    To view the full press release, visit the NAEMT web site at www.naemt.org. To view the latest information about the Field EMS Bill, visit here.

     

    As NAEMT President Don Lundy states “advocacy is a marathon not a sprint”, and we are surely moving closer and closer to the finish line because of your help. 


    The Professional Ambulance Association of Wisconsin signed on early to support the Field EMS Bill.

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