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October 14, 2013

Trial update: Attorneys scrutinize expert

(Continued)

CLINTON — Following his rundown of the issues in the documents, Henry and Walker's attorney Bob Waterman reviewed one of the non-compliant claims that was from a patient who reported left-ankle pain. The crew did not perform an ALS intervention on the patient and Clinton County did not have an emergency medical dispatch protocol, but it was submitted as ALS. Further, the narrative on the patient care report stated the paramedics decided to "BLS" the patient, all of which led Henry to his conclusion that it was not compliant with Medicare.  

"If there's no ALS interventions performed, in my opinion, it should have been submitted at the BLS level," Henry testified.  

Waterman then turned his attention to the duplicate reports containing different information that have been discussed since the trial started. Based on his experience, as well as testimony from Walker, EMS Director Andy McGovern and Firehouse software representative David Stanton, Henry concluded the duplicate reports could not have been the result of a computer or software problem.

If it had been the result of a computer or software problem, there would have been entire tables of information that were different, not single fields on the report, Henry testified.  

Henry said he concurred with Stanton, finding the duplicate reports "very suspicious." The duplicate reports supported the notion that there was intentional conduct to falsify claims, he said. These duplicate reports did not result in duplicate billing, according to prior testimony.  

When Blake Hannafan, who is representing the city of Clinton, started to question Henry, he dug deeper into the "issues" contained in the exhibits, calling them "errors."

Hannafan called attention to one of the claims Henry had identified as non-compliant that contained information in two places stating an ALS intervention was performed. Henry admitted he was wrong in labeling that claim non-compliant, reducing the number of non-compliant claims to 58.   

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