Emergency Medical Services Billing Audit Follow Up

FOR IMMEDIATE RELEASE: May 11, 2017

CONTACT: Danielle Perry, (773) 478-0534

Emergency Medical Services Billing Audit Follow Up

The City of Chicago Office of Inspector General (OIG) has completed a follow-up to its July 2016 audit of the Department of Finance’s (DOF) billing for emergency medical services provided by the Chicago Fire Department (CFD). Based on DOF’s responses, OIG concludes that the Department has partially implemented corrective actions related to the audit findings.

The purpose of the July 2016 audit was to determine if DOF billed accurately and completely for emergency medical services through its contract with a billing vendor. Our audit found that,

  • DOF billed accurately for emergency ambulance transports but opportunities existed to strengthen its compliance practices;
  • DOF’s billing for emergency ambulance transports was not complete, resulting in an estimated $160,799 of missed fee revenue in 2014;
  • DOF could increase fee revenue by an estimated $696,594 annually if it expanded the range of City-provided emergency medical services subject to fees; and
  • DOF could reduce costs by eliminating incentive fees from future contracts or, if the fees are maintained, clarifying how they are awarded.

Based upon the results of our audit, we recommended that DOF,

  • take measures to ensure that it bills completely for all billable transports, and consider expanding the range of services subject to a fee;
  • consider eliminating the incentive fees from its contract with the billing vendor as a means of reducing costs; and
  • if it does not eliminate incentive fees, more carefully review documentation used to justify monthly incentive payments.

In March 2017, OIG inquired with DOF regarding the status of the corrective actions the Department committed to in response to OIG’s audit and any other actions it may have taken. On the following pages we have summarized the four original audit findings and recommendations, as well as the Department’s response to our follow-up inquiry.

Based on DOF’s follow-up response, OIG concludes that DOF has implemented corrective actions to address the original audit’s first and second findings, partially implemented corrective actions to address the third finding, and has initiated implementation of corrective actions to address the fourth finding. Once fully implemented, OIG believes that the corrective actions reported by DOF may reasonably be expected to resolve the core findings noted in the original audit. We urge the Department to implement corrective actions, whether partially implemented or pending implementation, to resolve the third and fourth findings in our original audit report.

The OIG Emergency Medical Services Billing Audit Follow Up can be found online at OIG’s website: http://bit.ly/DOFEMS2.

Follow OIG on Twitter @ChicagoOIG for the latest information on how OIG continues to fight waste, fraud, abuse, and inefficiency in Chicago government.

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