“If we were doing something wrong, we would have been caught by now,” Schultheis said Wednesday, paraphrasing Atkinson. No one ever said the coding was a means to defraud the government, he
Schultheis was concerned the city, the fire department or individuals would be sued or lose their licenses because of the fraud, he said. While employed as a firefighter, Schultheis also had an insurance and real-estate business. He further testified that he believed he was being an asset and a leader when he filed his suit on behalf of the federal government.
He said he showed McGovern a Medicare manual and an article from a consulting firm about ALS coding, complained to all the firefighters on his shift and at union meetings and eventually contacted federal investigators about his concerns regarding the coding.
When asked why he never directly contacted then-fire chief Mark Regenwether, the city attorney or mayor about his concerns, Schultheis said he was told he should adhere to the chain of command. He said he couldn’t make an anonymous complaint because it would have become obvious very quickly that he was the one to submit the anonymous complaint. He never put his complaints in writing because he felt he didn’t need to, he testified. When he decided to talk to the feds about the alleged fraud, Schultheis went as far as to break fire department policy and the Health Insurance Portability and Accountability Act by secretly taking patient care reports of people who had been served by the city ambulance from the fire department’s computers. Schultheis did this at the request of federal fraud investigator Kory Ihnken. He took 30 to 40 reports home before sending them to Ihnken. He didn’t know if the reports he took resulted in claims that had been billed to Medicare, he testified.