First claim paid: lobbyist's son
By WILLIAM R. LEVESQUE, Times Staff Writer
For years, Florida refused to pay the hefty cost of flying an injured person to the hospital under one of the health insurance plans offered to state workers.
Then Allen Mortham Jr., son of former Florida Secretary of State Sandra Mortham, was burned in a brush fire and faced a $10,632 bill for a helicopter trip to the hospital.
His mother called a few friends in the state Legislature. Soon after, the Legislature approved the payment of such claims, and Allen Mortham's bill was paid in full.
State officials and Sandra Mortham say the change was long overdue and the state showed no favoritism. They say the state's PPO insurance plan was finally brought in line with a benefit offered by most private health insurance policies.
But a review by the St. Petersburg Times shows that the Florida Department of Management Services, which oversees the health insurance plans for state employees, paid Allen Mortham's bill while ignoring other state employees similarly saddled with helicopter bills.
DMS agreed to pay Mortham's bill nearly six months before Jan. 1, 2003, the date the Legislature set in its 2002-03 budget allowing the payment of such claims, DMS documents show.
DMS officials say they moved up the date to July 1 to quickly come to the aid of all employees with pending air ambulance claims.
But that explanation is contradicted by the agency's records.
Even by mid September, several months after Mortham was paid, nobody else had won payment for an air ambulance bill, records show. DMS only began making payments after one Pinellas family with an unpaid helicopter bill learned about Mortham's deal, asked DMS for records about the deal, and then told the Times.
"They take care of their own," said Mark Neimeiser, political director for the American Federation of State and Municipal Employees, the union representing most state employees. "That's unfortunate."
A DMS spokesman said the agency tried to first resolve the oldest claims caught up in an appeals process before getting to more recent claims.
"We wanted to treat everyone the same way," said DMS spokesman John Kuczwanski.
Former DMS secretary Cynthia Henderson, who approved the Mortham payment in July before leaving the agency on Jan. 7, did not return calls for comment.
Before becoming secretary of state, Sandra Mortham represented a Largo district in the Legislature and was House Republican leader in the early '90s. She is currently a legislative lobbyist for the Florida Medical Association.
Mortham said she worked with Henderson to get the Legislature to make the change. But Mortham said she didn't know why DMS agreed to pay her son's bill early.
Mortham said she didn't ask DMS to pay her son's bill and thought it was too late to help him. Instead, she said, she lobbied the Legislature to help others.
"A lot of times when things get personalized in the Legislature things happen faster," Mortham said. "My bigger issue was not Allen, because we would have found a way to pay the bill. I did not think any other state employee should be put into the situation of thinking they had great insurance, only to find themselves saddled with that sort of bill."
She said she called friends in the Legislature, including state Sen. Jim King, R-Jacksonville, a Republican leader who soon became Senate president.
King said Allen Mortham's case was the catalyst for making the change. But King said the change wasn't done to benefit just him.
"It just seemed damned unfair," said King.
King said he did not know DMS made payment to Allen Mortham before Jan. 1. That date was set for a reason.
"We pay our premiums in advance," he said. "You've got to pay the premium before you have coverage."
When Allen Mortham, 29, was injured in a brush fire at his Tallahassee home, he was covered by his wife's state health insurance. She worked for the Florida Department of Children and Families.
Paramedics flew Mortham to a burn center at a hospital in Gainesville on Aug. 28, 2001.
DMS initially refused to pay his insurance claim. During an appeal, the state agreed to pay him in early July 2002.
"They paid because we went through the process," Allen Mortham said.
About five helicopter insurance claims were outstanding at the time Mortham won his settlement, all of which DMS eventually decided to pay.
Pinellas prosecutor Joe Bulone and wife, Marjorie, were among them. Their 11-year-old daughter, Lauren, was thrown from a horse and knocked unconscious on Oct. 14, 2001, in Seminole. The girl was flown to a St. Petersburg hospital.
Doctors determined she had a concussion and no permanent injury. Then the bill arrived: $5,002. State insurance covered just $100.
"We couldn't believe something so basic as an ambulance ride wasn't covered," said Mrs. Bulone.
Joe Bulone talked to a lawyer about an appeal. The lawyer, who didn't take his case, had lunch with a DMS employee who mentioned the Mortham deal. The employee, whose identity Bulone never learned, passed along some advice.
"This person told me to put in a public records request and to call the newspaper," Bulone said.
He filed an appeal. On Aug. 8, he also sent a public records request to DMS. The agency never responded. In September, Bulone notified the Times.
Within weeks of the newspaper calling DMS to ask about air ambulance payments, Bulone was notified that his bill would be paid.
Eventually, four others who were appealing denied claims were told their bills would be paid.
Still, DMS ignored dozens of others.
From July 1, when DMS said it began paying air ambulance claims in full, to the middle of October, 24 state employees were charged for air ambulance costs that the state did not cover, records show.
After the Times asked why DMS hadn't paid those people for claims totaling over $80,000, DMS spokesman Kuczwanski said it was an oversight.
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From the Times state desk
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