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STATUS UPDATE REGARDING SEDGWICK COUNTY-ROBERT J. DOLE VA MEDICAL CENTER EMS CLAIM RECONCILIATION.
Presented by: Mike Scholes, County Manager, and Lindsay Poe Rousseau, Chief Financial Officer.
RECOMMENDED ACTION: Receive and file the updated status report.
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Background: In recent years, Sedgwick County EMS has responded to more than 62,000 requests for service and transported more than 42,000 patients per year. More than 1,100 of those incidents per year have been for individuals who had the VA as his/her primary medical care provider. As with any claim, EMS bills only for those claims where an individual has been transported to a medical care facility. Receiving timely payments for VA claims has been challenging since 2014, as of October 2017 a County report showed that the balance owed exceeded $1.5 million since 2014. The County is not alone; a February 2016 Kansas Emergency Medical Services Association survey of EMS providers found that 90 percent of respondents had experienced a slowdown in the processing of VA claims, with some reporting outstanding claims of three to four years. In response to these issues, Kansas Congressman Kevin Yoder sent a letter to U.S. Secretary of Veterans Affairs Robert McDonald on May 3, 2016, in which he said,
“I wish to bring to your attention an ongoing issue in my state concerning billing problems that some emergency medical service (EMS) agencies are having with the Department of Veterans Affairs (VA). Some Kansas EMS providers have reported significant delays in timely payment for services rendered for VA patients…Delays in VA claims have a ripple effect as well, because EMS agencies that transport a patient with VA benefits must submit claims to the VA before submitting to the veteran's other insurance or Medicare coverage. A substantial delay with the VA makes it difficult or impossible for the agencies to file claims with the other insurance providers in a timely manner. The EMS agency is then unable to claim any payment at all for their service. EMS providers are vital to public health and safety, and they play a crucial role in taking care of our veterans. However, they cannot provide their services if they never receive payment.”
In June 2017, the County’s external auditor pointed to a reduction in EMS receivable collections since 2014 as a deficiency. COMCARE cited the VA billing as a contributing factor.
At the Sedgwick County Commission meeting on October 18, 2017, Commissioner David Dennis identified an outstanding balance of $1.5 million and requested a meeting with VA leadership. On October 19, 2017, leaders from Sedgwick County went to the VA to meet with leadership about the claims. During the meeting it was determined a reconciliation would be completed between the organizations. Since then, dozens of meetings and conversations have occurred between VA and County staff. Today's presentation provides an update to Commissioners on the status of the reconciliation, along with recommendations for process improvements for the VA and the County going forward.
Alternatives: N/A
Financial Considerations: A reconciliation of oustanding claims worth $1.5 million has taken place. Going forward, new process improvements (monthly reports, quarterly meetings, etc.) are being recommended and implemented to avoid a recurrence of the issue.
Legal Considerations: N/A
Policy Considerations: N/A
Outside Attendees:
From the Robert J. Dole VA Medical Center:
Medical Center Director Rick A. Ament, FACHE.
Chief, Finance & Business Operations Management, Jennifer Dowell.
Kansas Congressional liaisons.
Multimedia Presentation: N/A