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Officially, the state has slapped GoldStar with three administrative penalties. The other two infractions came in 1999 for failure to notify the state of a change in ownership and "violation of a provider requirement." Among the state's ten largest EMS companies, only the Dallas Fire Department received as many administrative penalties in the same period. Brett Hart, the state's EMS complaints coordinator, says he cannot offer further information on GoldStar's penalties because the relevant documents exceeded the state's "retention schedule" and were destroyed.
Prompted by allegations of Medicare fraud, the FBI raided GoldStar's offices this April, according to former employees who say they tipped off the agency. A spokesperson for the U.S. Attorney's Office in Beaumont confirmed that the FBI searched the company's offices in seven Texas cities, but declined to comment on the investigation.
Five former employees contacted by the Pressclaim or allege GoldStar used a variety of techniques to bill Medicare for services not normally covered by the program.
One tactic involved pressuring paramedics to omit or change information in logs of ambulance trips, known as run reports, former workers say. The reports are used by the Medicare system to verify that the trips qualify for reimbursement with federal funds.
"There were people transported that didn't need to be transported," says Richard Kuehner, a paramedic who worked for GoldStar for eight months in the late '90s, "and they tried to encourage you not to document it in a way that would arouse any kind of suspicion.
"Like you couldn't say, 'The person walked to the stretcher, the person was ambulatory from the stretcher,' " he explains. "You had to say that you moved the patient to the stretcher. Things like that. Nothing that would indicate that this person probably doesn't need an ambulance for transport."
Pressure to fudge the reports bordered on the ridiculous, says Kenneth Lowder, who worked for GoldStar from 1998 to 2000. "There would be patients sitting ready to go in an electric wheelchair," he says. "But they would want us to write it a certain way so it would be paid."
Rothberg, the GoldStar attorney, said the company never engaged in Medicare fraud and described the allegations as "utter nonsense." He said that competitors or disgruntled former workers may have lied to the FBI in an attempt to put GoldStar out of business.
What nobody disputes is that GoldStar's profits in the late '90s were substantial. In a grant application submitted to the Port Arthur Economic Development Corporation, GoldStar pegs its 1999 revenue at $10.5 million and its net income at more than $4.3 million.
Mom-and-pop ambulance operators say they saw the company's flare-up coming. "For the seasoned people in the business, it just hasn't been a surprise," says the owner of a local EMS company who asked not to be identified. "I'm calling it our own little local Enron. I mean, seriously."
GoldStar obviously isn't headquartered in a gleaming, 40-story office building, but in some respects, the company may come tumbling down from even greater heights.
One test of GoldStar's stability took place in April, when a young man passed an 18-wheeler at high speed on a rural blacktop in San Jacinto County and crashed head-on into a woman in an oncoming car, sending it hurtling into a bank of trees. Her ribs were smashed. First responders dispatched Angel Flight, GoldStar's helicopter service, but the chopper's tail rotor broke mid-flight and the machine had to make an emergency landing in a nearby pasture.
San Jacinto County Constable Lou Rogers, who responded to the scene, was livid. "It was totally, unbelievably unacceptable what happened," he told GoldStar representatives at a public meeting. "When I call for a [helicopter], I want that son of a gun in the air on its way, and I want it here."
Breakdowns aboard responding medical helicopters, though rare, aren't unheard of, say veteran air medics. Yet GoldStar's safety record is plagued by more than the occasional bone of contention.
Last year a GoldStar pilot received a warning notice from the FAA for violating a safety reporting requirement, agency records show. The pilot was cited for breaking a rule that required him to record "each mechanical irregularity" that comes to his attention during a flight and to determine the status of the irregularity before the next flight.
In April, Thomas Gene Elder, a former GoldStar flight nurse and manager, sued the company, alleging that he had been fired after he reported "a potentially serious safety concern." Court documents do not elaborate on the issue, and Elder's attorney declined to comment on the case. As of press time, GoldStar had not submitted a response to the complaint.
On another occasion, GoldStar had to return to the launchpad on an emergency run when its personnel discovered they didn't have enough oxygen to supply the patient throughout the entire trip.
Profit-oriented EMS companies such as GoldStar own an increasing portion of the roughly 700 medical helicopters operating in the United States, and not all of them exploit their patients, says Ron Walter, president of the International Association of Flight Paramedics. They sometimes will base choppers in sparsely populated areas that nonprofit companies can't afford to service, filling an important role. "Some have very good business plans," he says.
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