Oklahoma`s EMSA Prevails on Appeal of Medicare Audit

Dec. 17--EMSA has won an appeal of a Medicare audit that accused it of improper billing practices, and the agency has been cleared of any wrongdoing.

It was refunded the $365,889 it paid after the November 2012 audit from the U.S. Department of Health and Human Services Office of Inspector General claimed fraudulent billing for transports in Oklahoma City during 2010.

"They found in all aspects that we have billed correctly," EMSA CEO Steve Williamson said.

The billing services for Oklahoma City and Tulsa are handled by the same personnel.

The Office of Inspector General has found numerous instances of billing fraud for ambulance service throughout the country and has been focusing or those organizations in the past few years, Williamson said.

The EMSA audit reviewed a random sample of 100 claims out of 21,855 and originally found that EMSA inappropriately billed and was paid for 10 of those claims.

Using those results, the audit estimated that EMSA had improperly billed for at least 1,210 transports and was overpaid $365,889.

EMSA chose to refund the government that money while filing an appeal to stop any interest from accruing.

It provided information on the disputed claims, which included fractured bones, a patient with possible sepsis and a patient with breathing problems.

Last month, EMSA received a decision on its appeal that was fully favorable for EMSA.

"That just speaks to the staff and the training," EMSA spokeswoman Kelli Bruer said.

For an ambulance transport to be covered by Medicare, it must be medically necessary and the condition of the patient must not allow transport by any other means, according to the audit.

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