In this special edition of the Fire Law VLOG, guest attorney Kevin Fairlie talks with host and national Fire Attorney, Curt Varone, along with Fire/EMS Attorney, Brad Pinsky, about the challenges of fire departments and EMS agencies when it comes to EMS billing. Many fire and EMS organizations are being audited and investigated for Medicare fraud. Brad and Kevin discuss certain solutions and strongly suggest that every EMS entity billing Medicare/Medicaid have in place a compliance program that meets the OIG's guidance on compliance programs for EMS providers.  EMS Compliance, LLC www.emscompliance.com is one example of a low cost and comprehensive solution.

​Attorney Kevin Fairlie, was recently interviewed and featured in the latest edition of EMS World magazine.

In the article, titled "COVID Vaccine Mandates for EMS: A Legal Roundtable" Kevin, along with two other industry experts, address key questions surrounding the issue.

Our Managing Member, Kevin Fairlie, was honored to teach the "Labor and Employment Law, Human Resource Management, Legal Issues and Trends" course last month at the ASM & CCM in Jacksonville, Florida!

Led by industry experts, Fitch & Associates, the Ambulance Service Manager (ASM) program is for aspiring, new and experienced managers who wish to develop their leadership competencies and sharpen essential management skills, the Ambulance Service Manager program provides a broad foundational curriculum that matches cutting edge management theory with real-life practical applications. 

The Communications Center Manager (CCM) is a one-of-a-kind program that presents the latest management and leadership practices used by emergency service providers around the world. It has proven to be successful for business leaders and students in implementing effective changes in today’s communication center.

Kevin Fairlie will be presenting at the Georgia Emergency Medical Services Association Directors and Leadership Conference in May. He will be discussing Employment Law issues as well as presenting on the new Medicare Cost Reporting requirements for EMS organizations.

​https://georgiaemsassociation.com/leadership-conference

Significantly, 2020 saw the largest number of new FCA cases initiated in a single year. Strikingly, the number of government-initiated cases against health care entities more than doubled from 2019 to 2020 and was at the highest level ever reported. 

Qui Tam (Whistleblower) Cases Continue to be the Driver.

Although we continue to see an increase in investigations based on random Medicare audits and internal Medicare reviews of your billing statistics, Whistleblower cases are still your biggest risk by a significant measure.  Remember, the FCA allows one of your employees (or multiple employees) to file an allegation of fraud against your organization.  If the government intervenes and is successful, the Whistleblower typically receives in the neighborhood of 20% of the total recovery.  With most FCA cases having settlements involving millions of dollars, this is obviously a big incentive for disgruntled employees.

To that point, total recoveries from Whistleblower actions generated almost $1.7 billion in 2020.  More than $309 million in Whistleblower share awards were paid in FY 2020.  The full DOJ report can be found here.

Kevin joins attorney Curt Varone for a Vlog and podcast at Fire Law.  The two discuss the compliance implications of the stimulus money deposited into most Fire and EMS agency bank accounts.  Watch and listen to the Vlog/Podcast at Fire Law Blog.

A big thank you to Curt Varone at Fire Law Blog for hosting Kevin Fairlie to discuss DOJ/OIG federal investigations into Fire Based EMS for False Claims Act violations and steps Fire Departments should take to avoid scrutiny. 

"In today’s episode, Curt talks with attorney Kevin Fairlie about the challenges facing fire departments who bill for EMS transports. Kevin’s law practice concentrates on health care related topics, but a recent spate of federal investigations across the country into fire department EMS billing practices has led him to represent numerous fire departments."  You can hear their entire podcast discussion at Fire Law Blog, Podcast 30: EMS Billing and Medicare Medicaid Fraud.

​Based on his years of experience with Medicare cost-reporting and his deep understanding of the EMS industry, our Managing Member, Kevin Fairlie, has been asked to write a number of articles recently on Medicare's new cost-reporting requirements for the EMS industry as well as state specific Medicaid cost reporting requirements.

Examples of these articles can be found in the Fall 2019 Missouri EMS Association (MEMSA) EMS Connection magazine  and the Kansas EMS Association (KEMSA) Chronicle magazine. 

More articles with current updates on this evolving topic are set for publication in other state EMS association journals and we will update you with those articles as they are published!

​This is a snippet of what EMS World had to say about Kevin's presentation:

"Accusations of false claims and negligence can send shivers down the spines of even the most careful EMS administrators. During “2019 Legal Update” at Pinnacle July 26, two experienced EMS attorneys brought attendees up to speed on current EMS case law and how providers and agencies can protect themselves." 

The entire EMS World article can be found here:  ​https://www.emsworld.com/article/1223025/pinnacle-ems-case-law-are-you-protected

From the May 2, 2019 Department of Justice Press Release:  ​A 46-year-old Houston man has been ordered to federal prison following his conviction of conspiracy to commit health care fraud, announced U.S. Attorney Ryan K. Patrick.  Full Press Release can be found here www.justice.gov/usao-sdtx/pr/ambulance-owner-sent-prison-health-care-fraud