Okla. Provider Has Sued More Than 100 Patients
April 01-- EMSA has sued at least 124 people in Tulsa County since 2009 who lived at addresses included in a utility fee program designed to pay for ambulance service, a Tulsa World investigation has found.
The findings call into question repeated claims by EMSA and some of its trustees that EMSA has mishandled only a few patients' cases.
Of the 124 people sued who were in the program, 108 lived in Tulsa and 16 lived in area cities, including seven defendants in Bixby and Jenks, where citizens cannot opt out of the utility program. The 124 defendants were named in 97 lawsuits filed since Jan. 1, 2009.
Those sued include an American Airlines mechanic who paid thousands out of pocket, a fast-food restaurant manager caring for her ailing mother and a single mother who took an ambulance after going into labor. The three are among 55 of the 124 defendants whose paychecks EMSA garnished or attempted to garnish.
EMSA CEO Steve Williamson declined an interview request. Spokeswoman Kelli Bruer responded to questions submitted in writing.
"To imply that the use of the court system is an abuse by EMSA of its relationship with its TotalCare members is superficial and misleading," Bruer said in an email.
"These suits are not mishandled. They are legitimate claims... The most common reasons are that the patient did not communicate with us to provide insurance information, or did not give us a correct address."
In many cases, EMSA served lawsuits at the patients' correct home address, which is listed in city records as included in the utility program.
A requirement EMSA instituted that patients become responsible for the bill if they fail to provide insurance information within 60 days has not been approved by the board or city officials. Mayor Dewey Bartlett has asked EMSA to eliminate the requirement.
The Emergency Medical Services Authority is a government agency that oversees ambulance service provided by a private contractor to more than 1 million people in Tulsa, Oklahoma City and surrounding cities. Citizens in those cities pay a monthly fee on their water bills, $3.64 in Tulsa, to receive ambulance service at no out-of-pocket cost.
The World provided EMSA with its findings and the agency reviewed each case. In about 80 percent of the cases, EMSA said the problem was due to patients failing to follow proper procedures or the agency had problems identifying the patient or their address.
The cases represent about one in four lawsuits filed by EMSA in Tulsa County since 2009, records show. Nearly all were filed in small claims court by the law firm Works & Lentz, which receives 35 percent of the funds it collects under a no-bid contract with EMSA.
A lawsuit filed by five plaintiffs in Tulsa District Court seeking class-action status names EMSA and Works & Lentz. The suit claims the two defendants fraudulently collected funds from customers enrolled in the utility program. Both EMSA and the firm have denied wrongdoing and filed motions to dismiss the suit.
Problem widespread?
EMSA trustee Dr. Ed Shadid, an Oklahoma City council member, said he was troubled by the World's findings. Shadid said he believes an investigative audit by state or city officials is needed.
Based on the World's findings "that would indicate enough statistical significance that there is a problem with the methodology ..."
At an EMSA board meeting last week, Williamson told Shadid the agency has no way to know how many people in the program accidentally paid bills they do not owe.
EMSA does not advertise the program, and citizens receive one annual notice about it in their water bills.
Other trustees, including Chairman Dr. James Griffin, said the billing issues were being exaggerated.
"I don't think this is really as big of a deal as it's being made out to be," Griffin said.
EMSA has refunded payments made by at least five patients and dismissed at least three lawsuits it had filed against people paying the utility fee, records show.
Amanda Carpenter, 34, was among those sued even though her address was included in the utility program.
"I just trusted. I thought I probably do owe this and that's the reason they are charging me," she said.
Bruer said: "The fact that TotalCare members were turned for collection isn't an immediate indication that an error occurred."
Bruer said issues that may affect EMSA's decision to file a lawsuit include: Was this an emergency or nonemergency transport; did the patient supply insurance information; did the patient give a correct home address to EMSA; and did the transport stem from a car accident in which third-party payor monies are available.
Trail hard to follow
Bruer said since the program started in the Tulsa area in 2007, EMSA has transported more than 308,000 patients in its eastern district. She said more than 62,000 patients have had all or some of their costs covered under the utility program.
Those figures show that EMSA covered part or all of the costs for 20 percent of patients transported in the eastern half of the state. Conversely, 82 percent of all city of Tulsa single-family residential utility customers participate in the utility fee program, records show.
EMSA sued at least seven patients who live in cities that have mandatory participation in the utility program. EMSA has since dropped one of those suits against a Jenks woman, citing "clerical error."
The defendant, Robin Kirkover Streveler, filed a motion to halt her garnishment.
"My mom has cancer," she states in a plea Jan. 23. "I just got back to work and have worked only one day thus far ... I cannot afford to pay this. My mom almost died and I needed to be there."
Records show EMSA dropped lawsuits last week against Melissa Carder and Mandy and Brian Scrapper, all of Tulsa, who are among the 124 defendants identified in the World's investigation.
Among the 124 Tulsans sued, 37 of the defendants were living in apartments and other types of multifamily housing.
City records of multifamily accounts often just list the name of the property owner at a mailing address that many times is different from the address of the patient. Individual names of apartment dwellers are rarely included in city of Tulsa records.
The World submitted to EMSA a list of defendants it determined were likely in the utility program at the time of their ambulance service.
EMSA disputed less than 20 percent of the cases submitted for review by the World. In those cases, EMSA said patients were served either before the utility program began or had opted out of the program on the date of service.
EMSA cited a variety of reasons for suing others identified by the World as patients covered by the utility program when transported. Most of the reasons cited for filing a lawsuit involved the patient not following EMSA procedures.
In one case, EMSA indicated: "had wrong patient address -- error."
Policy review mulled
EMSA trustee Clay Bird, economic development director for the city of Tulsa, said EMSA needs a mechanism to gather insurance and address information. However, Bird said he believes such policies should be subject to board approval.
He said he and other city officials are working on policy changes for EMSA board consideration.
"I think we ought to be able to identify who is in the program," he said. "That doesn't sound like a massive hurdle."
Other trustees said they did not believe EMSA has a systemic problem.
Trustee Dr. James Rodgers said an ongoing World investigation was taking up too much of EMSA's time responding to records requests.
"It's like there's a fly around the room and everybody thinks we are going to die from some fly," he said.
EMSA patients discuss their lawsuits
A dozen defendants in EMSA lawsuits spoke to the Tulsa World. EMSA said it would not address specific cases. A common theme of financial and emotional stress emerged. Here are three of their stories:
Christie Williams, Tulsa
Williams was transported by ambulance after a wreck totaled her car in 2009.
Williams' home has been in the utility program since December 2008, records show. She said she learned about the utility program from news accounts when it began.
"I think that was why I wasn't really worried about it (the bill)," she said. "I thought it would take care of itself, but it didn't."
EMSA sued Williams for more than $1,000, but she said she was busy at work and forgot about the hearing. Her pay was garnished.
Williams is a single mother of two.
"I ended up having to borrow money from Payday Loans, and it put me in a hole for six months," she said.
Amanda Carpenter, Tulsa
Carpenter, 34, said she was unemployed when she had the first of two seizures in 2008. She said five family members have died during the past three years and she has had difficulty keeping up with bills.
In 2009, Carpenter was working at Walmart when EMSA garnished her paychecks, records show.
Carpenter said she assumed EMSA would not charge her if she didn't owe money. Carpenter's apartment complex, Country Hollow, has been in the utility fee program since its inception, records show.
She did not go to the hearing after EMSA delivered her court summons.
"I just trusted. I thought I probably do owe this, and that's the reason they are charging me," she said.
Carpenter said she has contacted EMSA about a refund.
Carpenter is among 58 of the 97 defendants in Tulsa County who did not show up for court hearings in the suit, resulting in a default judgment, records show.
Angienatta Ayers, Tulsa
It was a rainy day in July 2008 when the vehicle in which Ayers was riding hit a puddle, spun out and wrecked on a Tulsa street.
Shaken, and with a possible back injury, Ayers was transported to a hospital by an EMSA ambulance, where she was treated and released.
Soon afterward, EMSA began billing Ayers for the $1,163 ride to the hospital. Ayers' insurance did not cover ambulance service and she was unable to pay the bill.
Attorneys representing EMSA garnished 25 percent of her salary from a local call center until the $1,163 debt was paid.
"It was a big chunk every week," Ayers said.
Ayers said she didn't know -- and EMSA did not tell her -- she was in the utility fee program designed to cover all out-of-pocket expenses for emergency ambulance calls.
Hospital employee, Tulsa
The paycheck of one Tulsa woman interviewed is being garnished to pay for the ambulance ride she took during childbirth. The woman asked that her name not be published due to her job at a Tulsa hospital.
When the woman got the bill for more than $1,000, she contacted EMSA to tell the agency she had given her insurance card to the ambulance driver. After the conversation, she mailed the agency another copy of her card.
EMSA sued the woman, who disputed the charges. During a court hearing in the case, the judge ordered EMSA to contact her insurance company. Afterward, the company told her EMSA never did.
She said the garnishment EMSA won is made worse by her employer. The Tulsa hospital charges employees a surcharge for taking money out of their check every time they are garnished.
- CASEY SMITH and CURTIS KILLMAN, World Staff Writers
Contact EMSA
EMSA CEO Steve Williamson said people who believe they were wrongly charged for services or paid ambulance bills they did not owe should call the agency. He said EMSA will give refunds if that occurred.
If you believe you have been wrongly charged for services, you can contact EMSA at:
Eastern Division (Tulsa): 918-396-2888
Western Division (Oklahoma City): 405-396-2888
About EMSA'sutility program
Began in Tulsa: July 1, 2007
Who is enrolled: All Tulsa residents who receive a utility bill are enrolled in the program unless they opt out by contacting the city of Tulsa by June 30 at 918-596-9511.
Apartment complexes can opt out of the program, but all residents must sign a form or be notified of that decision.
The utility fee: Tulsa residents pay $3.64 per month. The fee is listed on your utility bill.
The suburbs: The program exists in Sand Springs for $1 per month and residents can opt out. In Bixby ($1.80 per month) and Jenks ($2 per month) residents cannot opt out.
What it covers: Out-of-pocket costs for those with insurance or other third-party sources of payment, and all costs for those with no insurance.
Who it covers: All permanent members of the household.
Living in a place not covered?: If you live in a nonparticipating apartment complex or a nursing home, you can join EMSA's Total-Care program for $45 a year. That program has the same benefits as the utility program but no utility fee. Details are available on EMSA's website ( ).
Reporting the story
To arrive at the number of people in a utility fee program sued by EMSA, three Tulsa World reporters reviewed hundreds of court files, analyzed multiple databases and interviewed more than a dozen area residents.
The World first reviewed more than 400 lawsuits filed by EMSA in Tulsa District Court since 2009. Most cases were filed in small claims court, where claims must be under $6,000.
The review process included recording the addresses EMSA associated with the patients in court records.
Under the Open Records Act, the World requested utility customer databases from the city of Tulsa. The databases show customers' home addresses and whether they were included in the utility program or had opted out. EMSA also provided its database of utility customers.
The World created a database of people sued by EMSA in Tulsa County showing defendants' home addresses, case numbers, outcomes of cases, amounts sought, filing dates and other information. Addresses of defendants in the lawsuit database were matched with utility customers participating in the EMSA program.
Addresses of defendants were also compared to a database listing the month-by-month status of all addresses in the EMSA service area dating to 2009.
The World submitted to EMSA a list of patients that were likely in the program at the time of their ambulance run. EMSA challenged only 18 percent of the cases submitted for review as patients who were serviced either before the start of the utility program or living in addresses that had opted out of the program on the date of service.
- ZIVA BRANSTETTER, World Enterprise Editor
BY THE NUMBERS: EMSA
55: Number of garnishments initiated in Tulsa County
20 percent: The portion of all patients transported in the eastern district since 2007 whose transport costs were covered in part or in whole by the utility fee program.
82 percent: The portion of all single-family residential utility customers in Tulsa who pay a monthly utility fee
50 percent: The portion of all multi-family utility accounts that participate in the program
$13.7 million: Amount collected from utility fees from 10 cities with programs in fiscal year 2011
$50.3 million: Amount of revenue collected from Medicaid, Medicare, private insurance and direct payments from patients
$3.64: Amount of the monthly utility fee in Tulsa
$3.65: Amount of the monthly utility fee in Oklahoma City
Transports (FY 2012 through February)
37,873: Emergency transports, eastern division
6,806: Nonemergency transports, eastern division
45,747: Emergency transports, western division
1,625: Nonemergency transports, western division
$1,127: A typical emergency transport bill
$83: Typical court costs added to an EMSA patient lawsuit
$112: Typical attorney fees added to an EMSA patient lawsuit
$100,000: Amount spent by EMSA on marketing and public relations in FY 2011
$0: Amount spent by EMSA to date on advertising the TotalCare utility-fee program statewide
Up to $300,000: Amount EMSA has authorized for advertising the TotalCare utility-fee program in the Tulsa area this fiscal year.
Curtis Killman 918-581-9471
curtis.killman@tulsaworld.com
Casey Smith 918-732-8106
casey.smith@tulsaworld.com
Ziva Branstetter 918-581-8306
ziva.branstetter@tulsaworld.com
Copyright 2012 - Tulsa World, Okla.
