The Clinton Herald, Clinton, Iowa


October 5, 2013

Defendant: City knew there were EMS billing concerns


Mike Hannafan, one the attorney's representing the city, in prior days of testimony asked Walker why he didn't take any depositions in the 10 months he was retained by the city, including that of Schultheis. Walker testified he didn't want to depose Schultheis because he believed it would lead to McGovern being deposed and he had concerns about McGovern's credibility.

Concern over McGovern's credibility grew from comments from McGovern about the coding changes being dictated by changes in a computer program and automatically coding as ALS if an ambulance was sent for an emergency response. The fact that McGovern's way of coding directly contradicted the experts also raised concerns, Walker testified.

"He repeatedly said he's 'just doing it right,'" Walker said.

Purported coding and bill expert Douglas Wolfberg who the city retained for the fraud case relayed several of his concerns about the coding and billing during a conference call held on March 15, 2010. McGovern, Walker, former city administrator Jeff Horne, former city attorney David Pillers, finance clerk Sarah Nolan, and three other Hopkins and Huebner attorneys joined Wolfberg on that call.

Wolfberg commented on the city's 99 percent ALS billing rate, saying anything over 60 percent is difficult to defend, Walker testified.

The expert also commented on the city and county's lack of a protocol in place when dispatching ambulances. Without a dispatch protocol, the city was not entitled to code everything as ALS; the coding had to be determined by what was going on at the scene.

McGovern and former fire chief Mark Regenwether had been requesting a dispatch protocol since 2002, another red flag in Walker's eyes.

"I was concerned because it showed they knew they didn't have the protocol in place to do what they were doing," Walker said.

They also requested for billing to be outsourced, which Walker believed showed that McGovern was not comfortable with billing or wasn't trained to do the work.

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