Everett to repay $201,000 for insurance overbilling

The city also spent $153,500 on outside legal help and forensic accounting for the case.

EVERETT — The city of Everett recently agreed to pay the state and federal governments $201,000 over allegations that it overbilled public insurers for emergency medical services.

The city’s third-party billing vendor will pick up $25,000 of that tab, according to public records.

The city also spent $153,500 on outside legal help and forensic accounting in connection with the case.

The state Attorney General’s Office and the U.S. Department of Justice opened an investigation in 2015. At the time, there were headlines about former EMS division chief Pete Vier, who was accused of a sex crime and later convicted.

Vier had a long history of misconduct, on and off the job, which was documented in a series of stories in The Daily Herald. For a time, he oversaw the fire department’s ambulance billing.

In 2015, a TV news story alleged that he used that role to perpetrate billing fraud. City officials said there was no evidence of fraud. However, they said, Vier mistakenly thought the department could charge public insurers (mainly Medicaid and Medicare) a higher rate for advanced medical care for less-serious 911 calls, so long as a paramedic responded. Think, someone with a broken finger versus someone needing CPR.

No patients were overcharged directly, city spokeswoman Meghan Pembroke said in a prepared statement.

The city also hired outside help to conduct a forensic analysis into the fraud allegations. That cost $52,500. Outside legal bills were an additional $101,000.

Both the state investigation and the city’s analysis found no sign of “willful wrongdoing,” Pembroke said. Still, billing errors were discovered, and some billing practices were not in compliance with federal standards.

“We immediately corrected the error and ensured that all EMS staff and our billing agent were aware of the correct guidelines,” she said.

The Everett City Council approved the settlement Nov. 29. It was signed by the state and is awaiting federal review.

Rikki King: 425-339-3449; rking@heraldnet.com. Twitter: @rikkiking.

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