Agenda 09/26/2023 Item #16E 1 (Approve offer in full and final settlement of the EMS invoice regarding services rendered to Besart Marku)09/26/2023
EXECUTIVE SUMMARY
Recommendation to authorize the approval of the $1,116 offer in full and final settlement of the EMS invoice
regarding services rendered to Besart Marku.
OBJECTIVE: To authorize the approval of the $1,116 offer in full and final settl ement of the EMS invoice
DCOLL90378 regarding services rendered to Besart Marku.
CONSIDERATIONS: Besart Marku was involved in a motor vehicle accident on July 30, 2019. Collier County
EMS responded to the accident and services were rendered to Mr. Marku totaling $9,090. Mr. Marku’s PIP / No-
Fault vehicle insurance benefits were exhausted prior to the submission of the EMS invoice. Additionally, EMS
was not provided an insurance policy number initially and the health insurance information provided by Mr.
Marku’s personal injury attorney was not properly processed, leading to an outstanding balance of the entire
amount. At the time of the accident, Mr. Marku was insured through Allegiance, as a dependent of a Collier County
employee.
Mr. Marku’s personal injury attorney has offered to settle the outstanding bill for $1,116, the Medicaid
reimbursement amount, an 88% reduction from the billed amount. Due to the limited amount of the personal injury
pre-suit settlement from the adverse, at-fault driver, and the extent of the injuries sustained by Mr. Marku, the other
medical providers who treated Mr. Marku have accepted reductions of the outstanding balances. Additionally, the
Phia Group, on behalf of Allegiance, asserted a lien against the personal injury settlement proceeds and accepted a
reduced amount.
Resolution 2021-175 provides the procedures for EMS billing, including probate matters; however, the current
situation involving a personal injury case with damages and injuries that exceed the settlement obtained from the at
fault party is not contemplated in the Resolution; therefore, Board approval is required to reduce the amount owed
by Mr. Marku. The Resolution provides that for probate matters where $10,000 or less is owed for ambulance
services the EMS Chief and the County Attorney are authorized to take reasonable action to reach a settlement with
the personal representative or his attorney. Since less than $10,000 is owed for the EMS services and there are
limited settlement proceeds, it is recommended that the reduced amount be accepted to avoid Mr. Marku’s attorney
filing a Petition for Equitable Distribution. Should litigation proceed on this issue, it is likely Mr. Marku will
prevail and the County would owe Mr. Marku’s cost of litigation in addition to the reduced amount.
FISCAL IMPACT: If approved by the Board, the remaining balance of $7,794 would be waived and $1,116
would be accepted as full and final settlement of the invoice for the services rendered on July 30, 2019.
GROWTH MANAGEMENT IMPACT: None.
LEGAL CONSIDERATIONS: The terms of the settlement have been reviewed and approved by EMS and the
County Attorney’s Office. In the event the recommended settlement is not approved, the County can expect to incur
additional costs associated with litigation through a Motion for Equitable Distribution which will be filed in the
Collier County Circuit Court and a positive result can never be guaranteed with any degree of certainty. This
settlement is reasonable based upon the totality of the cir cumstances. This item is approved as to form and legality
and requires majority vote for Board approval. -CAK
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09/26/2023
RECOMMENDATION: To waive the remaining balance in the amount of $7,794 and authorize EMS to accept
the payment amount of $1,116 in full and final settlement of the invoice.
PREPARED BY: Colleen Kerins, Assistant County Attorney
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09/26/2023
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.E.1
Doc ID: 26313
Item Summary: Recommendation to authorize the approval of the $1,116 offer in full and f inal settlement of the
EMS invoice regarding services rendered to Besart Marku.
Meeting Date: 09/26/2023
Prepared by:
Title: – Emergency Medical Services
Name: Cherie DuBock
08/08/2023 4:26 PM
Submitted by:
Title: Division Director - EMS Operations – Emergency Medical Services
Name: Tabatha Butcher
08/08/2023 4:26 PM
Approved By:
Review:
Emergency Medical Services Tabatha Butcher Director Review Completed 08/08/2023 4:53 PM
County Attorney's Office Ronald Tomasko Level 2 Attorney of Record Review Completed 08/08/2023 4:58 PM
Office of Management and Budget Debra Windsor Level 3 OMB Gatekeeper Review Completed 08/09/2023 9:12 AM
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 08/09/2023 10:30 AM
Office of Management and Budget Agnieszka Chudy Additional Reviewer Completed 08/14/2023 11:35 AM
County Manager's Office Amy Patterson Level 4 County Manager Review Completed 09/15/2023 1:04 PM
Board of County Commissioners Geoffrey Willig Meeting Pending 09/26/2023 9:00 AM
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