As he represented the city, Walker told the City Council it faced a potential $40 million liability, which was based on a ratio from coding and billing expert retained in the Schultheis case, Douglas Wolfberg. According to Wolfberg, Walker told the council, the national average for ambulance calls is 60 or 70 percent ALS and 30 or 40 percent BLS. At the time, the city's Medicare billings were around 99 percent ALS.
Wolfberg's testimony in the legal malpractice case revealed this ratio was never meant to be construed as the national average and likely was relayed to Walker as a figure based on Wolfberg's experience and not hard, fast facts.
However, the 60 or 70 percent ALS rate was not far from the actual 64 to 68 percent average ALS rate from 2005 to 2008, according to the Centers for Medicare and Medicaid Services. The city now bills 86 percent ALS with billing handled by an outside agency since 2010, a fact the defense used throughout the trial.
The city's attorneys presented a dozen witnesses over the course of nine days. Former Fire Chief Mark Regenwether, Schultheis, Walker, Clinton firefighter Andy McGovern, Vulich, city of Clinton accounting specialist Sarah Nolan, Clinton firefighter Joel Atkinson, former Human Resource Director David Geisler, former Clinton Fire Department Medical Director Dr. Douglas Jergenson, Safety Director Jeff Chapman, firefighter Chris Melvin and False Claims Act expert Ronald Clark testified in the city's case. The firefighters denied the accusations Schultheis made that McGovern had told everyone to code everything at ALS and to give all patients a heart rate monitor, IV and oxygen. McGovern explained why he believed in his method of coding and that there was never any intent to defraud the federal government. They were shocked to learn the city had settled, they said.
If there were any incorrect claims, Hannafan told the jury, it didn't mean they were necessarily false or actionable under the False Claims Act. He argued Walker could have exercised innocent mistakes and negligence if the case had gone to trial.