Spokane’s new integrated medical services manager was in charge of the local American Medical Response operation during at least some of the years that the ambulance company systematically overbilled city residents, documents show.
But city officials say the problems began after billing duties were moved out of the Spokane office to AMR’s regional headquarters in Seattle between late 2002 and early 2003 as part of a corporate restructuring. The company agreed to a nearly $1 million settlement in 2010 over years of lucrative billing flaws involving Spokane residents.
Mike Lopez, who left AMR in 2004 to take a position with the state Health Department, began work Monday as a political appointee within the Spokane Fire Department. He’ll be responsible for seeking greater efficiency in the emergency medical services system while insuring compliance with evolving state and federal requirements.
Mayor David Condon said the city reviewed Lopez’s roles at AMR, given the earlier overbilling issues, and found nothing that caused concern.
“Mike was vetted extensively,” the mayor’s spokesman, Brian Coddington, added.
Condon said that by hiring Lopez, the city is getting one of the state’s top experts on EMS policy. He’ll be asked to streamline Spokane’s compliance and coordination with the integration of all medical services in a way that’s expected to make the system more efficient and potentially less costly.
“He has a significant amount of experience at the Department of Health,” Condon said. “Also, I hold everyone to the highest standards. Everyone in my administration is required to sign and abide by our ethics code.”
The overbilling was discovered several years after Lopez left AMR for the state job.
At the core of the dispute was how AMR billed city residents who called 911 for emergency services. In many cases, AMR charged those customers under the more expensive “advanced life support” rate when they should have been charged the cheaper “basic life support” rate if a Fire Department paramedic was involved in the ride-in treatment. The cheaper rate reflects the investment Spokane taxpayers already make in emergency medical services through operation of the city Fire Department.
Coddington said that while the billing complied with federal standards, no one at the company’s headquarters had contacted managers in the Spokane office to determine if there were local issues that needed to be taken into account.
In addition to the out-of-court settlement, AMR also was fined $80,000 in 2008 by then-Mayor Dennis Hession, who came under fire for imposing a much more lenient penalty than could have been imposed. The company said it corrected the billing problems as soon as they were discovered.
AMR has held a contract as the city’s only ambulance service since 1999, and documents show the overbilling had occurred since at least January 2003.
Lopez’s hiring is expected to be challenged by the labor union representing city firefighters.
Condon appointed Lopez to the position outside of civil service rules under a reorganization that was ruled illegal April 25 by a judge. The mayor contends that since Lopez accepted the position four days before the judge’s ruling, he should be considered “grandfathered” into the job. The city’s civil service director and others have raised doubts that the argument will hold up, though.
Monday night, the City Council formally repealed the fire department reorganization that substantially increased the number of political appointees that could be made without competitive testing through civil service. The repeal was approved 6-1, with two members who initially supported the plan last year changing their positions.
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