The Clinton Herald, Clinton, Iowa

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October 17, 2013

Jury begins deliberating malpractice case



The city's accounting specialist Sarah Nolan, who submitted bills during the time under scrutiny in the False Claims Act case, testified she didn't check the codes for accuracy and was not trained in ambulance coding, a fact her then- supervisor, former finance director Deb Neels, knew. Looking the other way is not a defense against the False Claims Act, Waterman told the jury.

"That's this case. I could stop now. That's what this case is about," Waterman said.

He also pointed out the fire department leaders, who supplied the patient care reports from ambulance runs that the finance department used to submit claims to Medicare and Medicare, assumed those in the finance department knew what they were doing. The right hand didn't know what the left hand was doing, Waterman said. By leaving out the finance department's lack of training, the city's attorneys didn't tell the jury the whole story, he said.

Waterman also contended that EMS Director Andy McGovern did not know what he was doing when he instructed paramedics how to code ambulance runs.

"It's like out of Matthew and Luke, the blind man should not lead a blind man because they will fall into a pit," Waterman said. "We've got the blind leading the blind."

McGovern and former fire chief Mark Regenwether's repeated requests for the city to outsource billing and institute a dispatch protocol were also relayed to the jury during closing arguments. Waterman pointed out since the city outsourced billing in 2010, its ALS rate has dropped from 99 percent to 86 percent, a 13 percent decline that he credited to the fact that someone is now verifying the codes before sending the bills. Waterman called the jury's attention to the 60 percent ALS, 40 percent

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