EMSA CEO Steve Williamson. DYLAN GOFORTH/The Frontier
Before the city of Tulsa launched its utility fee ambulance program in 2007, EMSA promised Tulsans in writing that “you’ll never pay out of pocket costs for emergency medical transports.”
EMSA’s president, Steve Williamson, testified Wednesday that statement in a utility bill flyer and a similar statement in a newspaper advertisement weren’t true. Williamson’s testimony came during the first day of a hearing to determine whether lawsuit plaintiffs will receive class action status.
Attorney Robert Pezold, representing four plaintiffs who say EMSA engaged in deceptive billing practices, questioned Williamson about the claims.
Pezold read Williamson the 2007 newspaper ad stating: ” ‘Residents will never pay a bill for emergency care.'”
“The ad represents what EMSA wanted in the ad,” Williamson said, though he insisted EMSA made no attempts to mislead residents about the program. He said elsewhere in the utility bill flyer and on EMSA’s website, residents who were paying the utility bill fee could find that fine print.
“Is that a true statement or isn’t it?” Pezold shot back.
“No,” Williamson answered.
Williamson said under questioning by EMSA’s attorney that the second page of the utility bill flyer informed citizens of the program’s requirements. At issue is whether EMSA adequately informed Oklahoma residents in the program they may be billed if they fail to abide by certain requirements including providing insurance information.
The hearing before District Judge Mary Fitzgerald is a crucial point in a lawsuit, now more than three years old, filed against EMSA on behalf of plaintiffs who say they should not have been billed because they were members of a city utility fee program.
The suit is filed on behalf of plaintiffs Priscilla Johnson, Robert Mitchell, Helen Mitchell and Tammi Papillion, who were billed for emergency EMSA transports between 2007 and 2011. The plaintiffs were paying fees on their utility bills that should have covered out of pocket costs for ambulance service but were turned over to a collections agency and sued, states the lawsuit.
Testimony Wednesday indicated thousands of Oklahomans in 14 cities could be class members if Fitzgerald grants the motion for class action status.
Fitzgerald is hearing testimony from witnesses regarding whether to expand the suit to cover people who may be due refunds, depending on the lawsuit’s outcome. Fitzgerald denied a request by EMSA to close the hearing to protect confidential medical records, indicating she will review records instead to ensure medical details are redacted.
During the hearing, Pezold questioned Williamson about a city of Tulsa study that found nearly 30 percent of all accounts turned over for collections by EMSA in a single month were members of the city’s utility fee program. The study examined accounts turned over to EMSA’s collections firm, Works & Lentz, in August 2011 and found 330 were actually paying the utility fee.
Williamson said in those cases, citizens had failed to give EMSA information it needed to pursue insurance claims. EMSA depends on recovering payments from Medicare, private insurance and other “third parties” to defray the cost of ambulance service, he said.
The suit originally named the Works & Lentz law firm, which filed suits against the plaintiffs, but the firm was dismissed after Fitzgerald granted its motion for summary judgment in March.
The Emergency Medical Services Authority is a government agency that oversees a contractor providing ambulance service to Tulsa, Oklahoma City and 14 surrounding cities.
Residents of Tulsa, Oklahoma City and the surrounding cities pay a monthly fee on their water bills in exchange for no out-of-pocket expenses for ambulance service under the program. In Tulsa, residents pay $5.45 per month to be part of the program while Oklahoma City residents pay $3.65 per month.
The suit claims that EMSA failed “to utilize any process of inspection of readily available records” when determining which customers to charge for its services. It also claims EMSA failed to advise the plaintiffs of appeal rights or how to dispute charges.
After the suit was filed, EMSA changed the description of the program, previously called TotalCare, on its website. EMSA now calls the program EMSAcare.
A key issue in the case is whether EMSA’s old rules requiring patients to provide insurance information to EMSA were incorporated and applied when the cities passed ordinances creating the utility fee program.
EMSA has denied the lawsuit’s claims that its billing practices were deceptive. A motion for summary judgment says the plaintiffs’ claims rely on “a confusing rendition of a revisionist history” of the ambulance program.
The agency claims that EMSAcare, formerly TotalCare, is really a single program with two ways to pay: a utility bill fee or an annual subscription.
In 2007, EMSA officials said the program would be a hassle-free way for residents to avoid out-of-pocket costs such as deductibles for ambulance rides. They said those without insurance would pay nothing.
However a 2012 Tulsa World investigation found the agency sent bills to at least a dozen people who
were transported in EMSA ambulances and were paying the monthly utility fee, according to city of Tulsa records. All said they received bills that failed to indicate they were members of the utility program and thus owed no out-of-pocket costs.
EMSA records show that along with a request for insurance information, all patients — including those in the utility program — received a bill that stated “due from patient” showing a dollar amount owed. It also stated “due date: upon receipt” at the top and provides an address to send payments to EMSA.
The agency later changed the bills, adding language in most cases that indicates patients are members of the city utility program and do not owe the charges.
A World review of lawsuits filed by EMSA in Tulsa District Court found 124 people who lived at addresses that city records showed were included in a monthly utility program. Of the 124 people sued who were in the program, 108 lived in Tulsa and 16 lived in area cities, including seven defendants in Bixby and Jenks, where citizens cannot opt out of the utility program. The 124 defendants were named in 97 lawsuits filed between 2009 and 2012.
The class hearing continues Thursday in Fitzgerald’s courtroom. It is unclear when she will rule on the motion.
