Archbold, OH

Problems Found In EMS Billing; Director Fired

The Fulton County Commissioners terminated Bob Hartman, Fulton County Emergency Medical Service-Emergency Management Agency director, Monday, June 16, after inaccuracies in billings for EMS runs were discovered.

“Bob is a good person. He moved us (Fulton County) forward” in terms of emergency preparedness, Joe Short, Fulton County commissioner, said Monday.

However, Hartman’s responsibilities included oversight of the billing for EMS runs, and there were problems in that area.

There are bills that were never submitted to Medicare and Medicaid, the federally funded health care programs for those over 65 and the poor, respectively. There are also bills that were not given proper medical codes. The county was paid for those improper-coded bills, but may be forced to refund the money.

The bulk of the problem bills are for non-emergency transfers, Short said.

Short said the full scope of the EMS billing problems is unknown, because two separate audits are not complete.


In 2002, Fulton County voters passed a two-mill levy to fund operation of four advanced life support paramedic units, plus money for the county’s three smaller fire departments (Fayette, Lyons, Metamora) to assist them in operating their rescue squads.

At that time, the county commissioners agreed to begin billing patients for rescue calls. For Fulton County residents, whatever Medicare, Medicaid, or private medical insurance paid is accepted. Out-of-county residents are required to pay the full bill.

At that time, Life Star, a private medical billing firm based in the Toledo area, was in charge of processing EMS run bills. The commissioners paid Life Star a fee for the service

Dean Genter, Fulton County commissioner, said in 2006, Hartman urged the commissioners to take the billing away from Life Star and begin doing it in house. The theory was the county could save the money it was paying the private firm.

Short said during 2007, the commissioners had questions about EMS financial reports that were presented to them.

“Things did not make 100% sense,” Short said.

In early 2008, a routine state audit of EMS bills started.

About four weeks ago, Short said state auditors told the commissioners they had found inaccuracies in the EMS billing.

Employee Terminated

Several months ago, an employee in the county EMS-EMA office was disciplined over irregularities involving a county vehicle and an out-of-state trip for training. The employee used the vehicle for personal business.

Genter said as part of the disciplinary action, the employee signed a last-chance agreement, stating that if there were further problems, the employee could be terminated at will.

There was another problem, again involving a road trip and a county vehicle, and that employee was terminated on June 2.

At that point, Life Star was asked to review the EMS billing records, starting from 2006, when the county took over the billing.

So, in addition to the ongoing state audit, Life Star is now also looking into the EMS billing records.

Short said the county has 18 months in which to submit bills to Medicare, and 12 months to submit bills to Medicaid. There are bills that the county may not be able to collect, because they are outside the time frame.

No Criminal Action

Short said there is no potential for criminal charges against anyone in connection with the EMS billing problems.

“In no way, shape, or form do we believe that money was taken,” Short said.

Nor is the county EMS system anywhere near collapse. A chart provided by the county commissioners in a Monday press release puts the fund balance in the ALS program at more than $2.6 million, while expenses in 2007 were under $2 million.

But revenue from the twomill ALS levy is about $1.6 million, so revenue from EMS service bills is necessary to make up the difference.


In the meantime, Short said Rod Cheney, Archbold firefighter and paramedic who is also on staff at the EMS-EMA office, agreed to be interim EMS-EMA director.

He will be assisted by Jake Manz, a former EMS-EMA assistant director. Manz has many years experience in EMS, EMA, and law enforcement.

On Tuesday, an emergency meeting of the EMA board executive committee was scheduled to meet to approve the appointment of Cheney.

In a press release announcing the EMS billing problems, Short said, “As leaders, we wanted to share with you the Emergency Medical Service office, like all other county offices, are being monitored and held, by us, to standards that are worthy of your continued public trust.”

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