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| Someone is looking to score a payday! |
The board was made aware late last week of a recently filed complaint against the county in Federal Court. This complaint is being made under the Federal False Claims Act. The allegations and insinuations are numerous and wide-ranging. Everything but the kitchen sink is thrown into the complaint--which initially was filed under seal with the court back in September of last year. Like a Jackson Pollock--stuff is thrown all over the place in this filing. like spaghetti all over the wall....The Angst oozes from the pages of the complaint (currently being redacted in the legal office) which I will post once it is scrubbed of any sensitive, HIPPA or other confidential information which cannot be released.
I've read all 58 pages.
It reads like the manifesto of an angry, scorned former employee short on facts and long on allegations and requests for data--which is probably why the Federal Government took a "hard pass" on joining this suit. I'm sure the former medical director and her Miami and Pennsylvania lawyers were hoping the Feds would join--but they didn't. Which may be telling. Language like this, below, directly from the complaint--sounds a lot like a "fishing expedition"...
"With respect to allegations made upon information and belief, Relator has, based upon Relator's knowledge, data, and prior experience, a reasoned factual basis to make the allegations herein but lacks complete details of them. While Relator has significant evidence of the fraud alleged herein (the details of which follow), much of the documentary evidence necessary to prove these allegations is in the possession of Defendant.."
Meanwhile-the staff that remains in billing and EMS will have a Herculean "Data call" coming: They will have to compile the billing and call coding information from different billing systems over a long period of time where multiple personnel have come and gone over the timeframe indicated (2014-2020). Multiple EMS and Public safety employees, multiple budget directors, multiple EMS and public safety directors, three IT directors, and at least four current and former Interim and permanent County Administrators have been employed over this time.
When this was dropped on the legal office's lap just last week-- on January 18th-- by our Insurance-company assigned Law Firm--we were given only 9 days to answer this nearly 60 page complaint--even though our "insurance company assigned attorneys" knew about this complaint since November. so there are issues with that, too, that I'll get to in some additional, follow-on posts.....meanwhile, we have subsequently received an extension which will allow us until February 10th to file a response. But as it pertains to the allegations, this post will be about that.
In a nutshell, the former Medical Director has teamed up with a couple of Lawyers to accuse the county of systimatically, purposely and illegally over-billing the government for EMS transportation services provided in our county over nearly a seven year period. In addition to that, they are claiming the county billed for ALS services while only providing BLS services. They also claim some of the personnel were allegedly not certified properly for the reimbursements requested. The allegations are all listed one by one after a narrative that names a lot of names and lists a lot of serious allegations these individuals are alleged to have engaged in during the course of their employment with the county. (Interesting that most of the individuals named are no longer employed by the county, and the "sinister allegations" made in this complaint do not mention the fact that the lion's share of these employees have now moved on with their respective careers elsewhere after disproving or settling the allegations of this former medical director hurled at them. I do not believe any of these individuals named in her complaint has been adjudicated guilty of her allegations. Most of these allegations and charges have been dropped and settlement agreements made allowing these former employees to all to continue their careers in public safety).
The most interesting thing about this suit is that if successful, the plaintiff (former medical director) and her lawyers can collect a portion of the fees owed to the government--which could amount to a lot of money if every allegation is proven--because Qui Tam complaints, I'm told, allow folks to sue on behalf of the government. If successful, a finding can be made forcing a party (in this case the county) to repay the government and the complainant. Looks to me like someone is looking for a payday! Ka- Ching!!
Interesting to me is the fact that she, the former medical director, was essentially in charge of this department for a multi-year period---and among all the drama, requests for training, requests for other things, bigger budgets, "we must have Rescue 1" etc. and even more drama-rama complaining--I don't recall this medical director once, not once, letting the board know she saw a problem with the billing/coding. Not once. She came to meetings, she complained about everything EXCEPT anything having to do with the billing. So she was in charge, never mentioned this as an issue, and is now suing for this issue? Why is that, I wonder?
Too many questions.....
Much more to come on this in the days, weeks, and months to come.
Initially, I'm told at least one employee intimately familiar with the coding and billing issue has stated unequivocally that the allegations are untrue and that coding was/is always done conservatively--meaning the lower cost transport was the default billing unless it is/was known that the call was an acute call which bills at about $100 more than the rate for a routine transport. But the county's staff will have to compile reams of data in order for a defense to be constructed and prior to a cogent response being drafted to this wide-ranging complaint. Staff will have their work cut out for them over the next three week which will go by quickly.....
From the complaint:
"1.
Plaintiff-Relator Dr. Edler brings
this False Claims
Act Complaint on behalf
of the United States, and on
her own behalf. 31 U.S.C. §§ 3730 et seq.
2.
Medicare and other government programs pay for certain
necessary and reasonable medical
services, but services are not
reasonable when they are performed by uncertified and unqualified personnel. Escambia County knowingly filed
claims for medical services performed by
uncertified and unqualified personnel.
3.
Further, Escambia knowingly filed
claims for emergency transportation when it provided
non-emergency transportation, and it filed claims for advanced life support when if provided basic life. These up-codes are false claims."
7 comments:
I'm no lawyer but it seems to me if the federal government did not wish to be a part of this, then it should be dismissed and the staff doesn't need to jump through the hoops for the entertainment and power ploys of vexatious litigation.
Commissioner Bergosh, are you sure this isn't the same suit she brought before, with an amended complaint?
She filed qui tam against the county with her typical nonsense back in May 2020. I kept asking for a long time what the heck ever happened with that complaint.
Just looked it up--case number 3:20CJ 5503 RVI-HTC
Wouldn't surprise me if she's doing the same thing as she did when she was suing me--kept putting in "amended" complaints that were just more horseshit strung onto it. Each one was a signed affidavit (that had lies strung throughout), and each replacement complaint got longer. It's a litigation strategy to confuse opposing counsel, as well, because they often put different information in each complaint and try to get the other side tripped up (good luck when the other side is JJ Talbott...didn't work out too well for them).
I haven't read through the original filing on that case for a couple of years, but it was CHOCK full of bad information in the original complaint, FYI. Of course that will be a shocker to absolutely no one but the few fools left who still listen to Doug and Jacqueline. He of course knew what Edler was--mirror images. JAR being the dull blade was left to saw things over on ECW not ever really knowing what was true and what wasn't, as her cognition had been pretty addled by Doug's lies and his manipulations of her, and her own disinformation tactics, at that point.
ps. I sent an email to the County in July 17 of 2021 pertaining to what I believe is this suit:
"As a taxpayer, I know I speak for many in growing very tired of Ms. Rogers either bringing or supporting failing suits that are racking up enormous expense on the taxpayer dime, and feel that your office should be aware that she is not resting content at all of her previous legal filing and peripheral meddling: a multitude of land use suits, claiming during Dr. Edler's suit against me that I was the plaintiff, disinformation about how DOAH works and claims of its corruption, libelling Matt Selover throughout his successful civil suit, declaring him already guilty in his DOH matter, claiming the SAO dropped the charges on Steve White to set him up as a "rat" on the others, assuring everyone that any Escambia employee with probable cause or charges are all guilty as found and charged.
Apparently not satisfied with her results on all of that and more, she is now trying to drum up support for Dr. Edler's suit against the County."
Also this:
"As a result of my interview by Mr. Williams on Thursday, I will be providing him with public record that could in some way be exculpatory in the criminal cases, and that I don't believe the County has yet provided his office with--the harassment complaints the County hid (which contained information pertaining to certificates), Dr. Edler's interview process, where SERA laws were admittedly broken to bias the proceedings for her, Sergeant Champion's medical billing investigation (which includes perjured sworn statements that pertain to the criminal cases), legal documents, etc.
And of course all of that pertains as well to the labyrinthine, Gordian legal nexus--civil, administrative, criminal--that Dr. Edler has visited on the County, with disinformation traffickers such as Commissioner Underhill and Jacqueline Rogers greatly assisting in the hundreds of thousands--perhaps even millions, at this point?--of dollars of taxpayer expense, cumulatively, as a result.
It occurred to me today that, as Ms. Rogers has claimed to have inside information on all aspects of these matters from start to finish, and now seems to be hinting she once again has early information about a shade meeting--the contents of which should be off-limits to her, as they are to other citizens--it might be helpful for the County to depose her and find out what it is that she knows that the rest of us are ignorant to. She has also professed to have insider knowledge of the guilt of the people arrested, during the period they should still be considered innocent, and this has big implications not just for the criminal cases, but for any civil case pertaining to Dr. Edler to get a fair hearing.
At any rate, County legal should be aware that over the last week, the usual suspects on ECW have been doing everything in their power to disinform and bias the public about multiple legal issues pending per Escambia Public Safety, and this morning they have now escalated it to claiming that Commissioner Bergosh was retaliatory against Dr. Edler, and are trying to drum up public outrage over that notion, like they do. I suppose in an attempt to pressure the BOCC and the Attorney's office into finally awarding Dr. Edler--who has told multiple people she came to the County on a vendetta, and seems to have been bent on putting the County at huge liability since day 1--with the big settlement that has so far eluded her various attempts."
It appears Melissa Pino is a wealth of information the average citizen is not entitled to see. Has the county investigated for a leak? Maybe she's full of BS but one day she will cost the county a lot of money.
Is this the same one from a couple of years ago or a new one?
4:46, Invest a quarter of a million dollars towards battling a frivolous defamation suit down in order to get an administrative railroading and coverup exposed on the court docket; hire an esteemed criminal attorney to meet with the prosecutor from the State's Attorney's Office and the investigator from FDLE; gain press awareness of that you were never lying about anything from the get-go; and effect a shift in public opinion as the common-sense majority comes to realize what was really going on. You would no doubt get the same results.
Irony: I could indeed have cost the County a lot of money, by suing the crap out of the public officials across two administrations who orchestrated this mess and didn't discipline a rogue employee under their supervision for various frauds, including her suit against me. Because I recognize that "County" equals "the taxpayers," however--unlike fake "advocates" and "whistleblowers" such as Edler and Jacqueline Rogers who are in it for their own material gain--I choose to focus on the win of exposing the bad actors and, more important, assisting the County employees who were framed in debunking their criminal charges.
You should try being on the good side once...you might find that you like it.
I don't believe your attorney fees for that case were a quarter million bucks and if it did you should have contacted the sheriff's department to file a robbery report. He's a personal injury attorney. I recall you once said it cost you $100,000. That's a big jump. Patting your back for all your good deeds doesn't make it anymore believable.
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