SEC TOURNAMENT
IT’S KENTUCKY VS. TENNESSEE SPORTS UP TO
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$171
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SUNDAY • 03.11.2018 • $4.00 • FINAL EDITION
A BOY’S CAMPING ACCIDENT.
A LIFESAVING AIRLIFT.
STICKER SHOCK
Privacy laws provide little precedent in Greitens case BY KEVIN McDERMOTT St. Louis Post-Dispatch
PHOTOS BY LAURIE SKRIVAN • lskrivan@post-dispatch.com
“Watch me do a back flip,” says Ben Millheim, 8, as he jumps on the trampoline in his backyard this month in south St. Louis County. In 2016, Ben was airlifted from rural Missouri to SSM Health Cardinal Glennon Children’s Hospital after fracturing his skull during a camping trip with friends and family.
Family receives bill for $32,000 from Anthem after their son needed a ride in an out-of-network air ambulance
Ben Millheim fractured his skull after falling about 13 feet during a camping trip with family and friends in the fall of 2016. After racing into town to get a cell signal, the family finally reached an ambulance by phone. Upon seeing the injury, the family was told the unconscious boy, who was bleeding from his ears and having seizures, would need to be airlifted to a hospital in St. Louis, more than 100 miles north by car. Fortunately, Ben survived. But the family has been caught in the middle of a billing practice that can have devastating financial consequences for patients. What the family didn’t know at the time of the accident was that the air ambulance was out of network. Now they are on the hook for more than $32,000. They’ve exhausted all their appeals with Anthem Blue Cross
TODAY
For Bulldog
40°/31°
Who goes marching in?
Loaded miles
$23,940.00 +$19,546.50
Night call
+ $351.00
Disposable supplies
+ $254.98
EKG monitoring 3 leads
+ $103.50
Dextrostix — blood glucose
Air Evac total
BY SAMANTHA LISS St. Louis Post-Dispatch
See AIRLIFT • Page A4
Base rate RW night call
Insurance payment
Final bill
+ $36.13
$44,232.11 — $11,787.03
$32,445.08
One was a Lincoln County horse riding trainer charged with recording his teenage student changing in a dressing room. She ran from the room after noticing a small square camera with a red flashing light sitting on a table. Another was the employee at a Warren County home for developmentally disabled adults who allegedly took a video of himself removing clients’ clothing while they were asleep and then shared it with friends via Snapchat. Then there was the Ozarks man charged with hiding a camera in the bedroom of his home to take video of a relative undressing. He got caught after posting it to his Facebook page. Missouri Gov. Eric Greitens is in some disturbing company as a defendant charged under the state’s felony invasion-ofprivacy law. See GREITENS • Page A7
In a ballroom with antlers on the wall and hoof prints on the carpet, diversity coach Miguel Joey Aviles asked whether anyone knew how to merengue. “Lord have mercy,” he said, counting hands. “Only two?” This is “Hispanics 101,” a class meant to teach employers in the Ozarks resort town of 11,400 how to lure workers from Puerto Rico and persuade them to stay. The economy depends on it. As tourism season kicks off this month, the remote getaway known for dinner theaters, country music concerts and a museum of dinosaur replicas
Spring forward
PARTLY CLOUDY begins Sunday. Don’t forget toWEATHER set your B11hour clocks one POST-DISPATCH WEATHERBIRD ® ahead Saturday night.
Daylight saving time has begun. You should have set your clocks one hour ahead Saturday night.
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has 2,050 vacancies — and a lack of locals applying. So, like other areas with tight labor markets, Branson finds itself getting creative to fill jobs — in this case by recruiting people from a part of the United States with much higher unemployment. But the plan to bring 1,000 workers from the island to overwhelmingly white, conservative Branson over the next three years has sparked unease, with critics saying that the newcomers will steal work from residents or drag down wages or bump up crime. Inside the mountain lodge with Aviles, however, managers See BRANSON • Page A7
Express Scripts deal worries health plan clients • D1
RAIN/SNOW LIKELY
Daylight46°/28° saving time
POLITICAL RISKS Defense strategy could have repercussions on extent of consent, privacy beyond governor’s case
Locals aren’t applying, so businesses get creative to make islanders feel welcome
For Sunday main
SpringTOMORROW forward
WIDER APPLICATION Evolving technology is pushing the law to catch up with offenses
Ozarks looks to fill jobs with Puerto Rican workers BY DANIELLE PAQUETTE Washington Post
Dan Millheim sits with his wife, Melissa, this month in their South County home. They were charged more than $32,000 for their son’s 83-mile ride in an air ambulance. They have tried to get Anthem to pay a larger share of the bill, but the insurer has refused.
WHAT IS ‘REASONABLE’? Convictions that stem from consensual sexual encounters are rare
Messenger: Mice underfoot and bullets overhead • A2
Get dirty, join a cave club
No rest for Tommy Pham
Spring arts preview
Missouri is honeycombed with 7,300 caves
After big season, center fielder stays focused
Your guide to festivals, music, theater and more
HOME & AWAY • H1
SPORTS • B1
A&E • C1
Gunman at veterans home ‘clearly had demons’ • A9 Getting kids up to code
2 M Vol. 140, No. 70 ©2018
• D1
A4 • ST. LOUIS POST-DISPATCH
FROM A1
M 1 • SUNDAY • 03.11.2018
“THE WHOLE REASON FOR HAVING INSURANCE IS TO COVER THIS TYPE OF STUFF.” Dan Millheim, Ben’s father
ROBERT COHEN • rcohen@post-dispatch.com
A member of the Air Evac Lifeteam crew prepares a helicopter based in Troy, Mo., at Mercy Hospital Lincoln for a morning flight on Friday.
Missouri has no laws that limit balance billing by insurers AIRLIFT • FROM A1
Blue Shield, the insurance company that covered the south St. Louis County family of five at the time of the accident. The family has tried to get the insurance company to pay a larger share of the bill, but Anthem has refused. “Obviously, no one plans for a situation like this, and hopes it never happens, but the whole reason for having insurance is to cover this type of stuff,” Dan Millheim, Ben’s father, said.
BALANCE BILLING Anthem is one of the state’s largest insurers. Millheim purchased the family coverage through HealthCare.gov, an online marketplace for consumers to purchase insurance. The total amount billed for the transport was $44,232. Anthem paid Air Evac Lifeteam $11,787, leaving the Millheims with a bill of $32,445, according to documents provided by the Millheims. “My jaw hit the floor,” Millheim said upon seeing how much they owed. The practice is known as balance billing. It’s when out-ofnetwork providers stick patients with the difference between what the provider billed for and what the insurance carrier paid the provider. To be considered in-network means providers and the insurance company have agreed to certain rates for services. Some states have passed legislation to limit balance billing, but Missouri has not, according to a report from the Commonwealth Fund, a private foundation that focuses on health care issues. And state legislation may not have an impact in regulating this corner of the health care industry due to how air carriers, including air ambulances, are regulated at the federal level. There are no federal protections that ban this billing practice, according to the Commonwealth Fund report. “Patients are exposed to enormous financial risks if they need an air ambulance transport,” said Erin C. Fuse Brown, a health law expert at Georgia State University. “There is no way to tell whether the ambulance is in-network, no requirement that insurers have air ambulances within their network, and no way to anticipate or avoid a devastating balance bill if the air ambulance turns out to be out of network.” In the Millheims’ situation, the insurance company and the air ambulance provider are pointing fingers at each other. The insurance company has balked at the prices being charged by Air Evac, while Air Evac claims Anthem is underpaying for the service. “I will stand behind my charges,” said Seth Myers, president of O’Fallon-based Air Evac. “They’re the bad actor,” he said of Anthem. He said Anthem suddenly stopped paying what he called “a reasonable amount” just a few years ago. “I want to take the patient out of the middle of this problem,” Myers said.
ASSOCIATED PRESS
In this 2008 photo, staff from I-70 Medical Center and Air Evac Lifeteam transport a patient to University Medical Center ICU in Columbia, Mo.
MEDICAL COSTS Reporter Samantha Liss is focusing on medical costs. Do you have a bill that you consider excessive? You can contact her at sliss@postdispatch.com for possible use in a future story.
The majority of patients his company transports have government-sponsored health plans such as Medicaid or Medicare, or are uninsured. Because of this, he said the company relies more heavily on private insurance to make up for what it doesn’t earn on Medicaid or Medicare patients. Patients with Medicare and Medicaid are protected from receiving a surprise bill like this that amounts to the difference between what the insurer pays and what the out-of-network provider charges. “It’s the same thing that’s happening all across the health care industry,” said Shelly Schneider, a spokeswoman for the company. The company encourages consumers to buy annual memberships, which Schneider says will protect them from being stuck with the difference between what their insurance company pays and the cost of the transport. Annual memberships cost $65 per household, Schneider said. However, there’s a chance another firm could pick up an Air Evac member after an accident, in which the membership deal would not apply. Air Evac and three other major firms are included in the membership, which has more than 320 air medical bases across 38 states. Together, there are currently 3 million consumers enrolled in the membership program. The membership is not con-
sidered insurance and is not regulated by the Department of Insurance. Air Evac Lifeteam is part of Texas-based Air Medical Group Holdings, which claims to be the largest independent provider of emergency air medical services. Air Medical Group Holdings is owned by New York-based investment firm, KKR. “If the patient cannot afford the balance, our patient accounts will work with them to set up a monthly plan,” Schneider said. Critics say there is no incentive for air ambulances such as Air Evac to agree to pricing terms with insurance companies to become an in-network provider. However, Air Evac said Missouri’s other largest insurers — Blue Cross Blue Shield of Kansas City and UnitedHealthcare — pay a reasonable rate even though they’re out of network. “The insurance company has an obligation that protects people in emergencies, and that means they should have adequate coverage of ground ambulance and air ambulance,” said Sidney Watson, a health law professor at St. Louis University. Because Anthem and Air Evac can’t come to pricing terms, families such as the Millheims are left in the middle. “He was unconscious, having seizures and bleeding out of his ears. For the insurance company to turn around and pass the bill on to us seems incredibly cruel and outlandish,” Dan Millheim said. The state insurance department received 15 complaints against insurers on the issue of air ambulances last year. The department has investigated 53 complaints since 2013. Meanwhile, SSM Health Cardinal Glennon Children’s Hospi-
tal, where Ben was taken, said it receives about 700 patients annually via air ambulances.
REGULATING PRICE A law that was meant to spur competition in the airline industry has caused issues for states and plaintiffs when it comes to addressing the price of air ambulances. The Airline Deregulation Act of 1978 bans any state from regulating the price or routes of air carriers. Air ambulances are considered to be air carriers, so when consumers have sued air ambulances, claiming a violation of state consumer protection laws, their cases often are dismissed. In one case in Oklahoma, Judge David L. Russell dismissed a 2017 lawsuit against Air Evac, but in his order he said he sympathized with the plaintiffs that “these rates are unfair.” In 2014, the median price for an air transport was $30,000. Just four years before, a transport priced at $30,000 was in the 95th percentile — “meaning 95 percent of all prices charged were below that amount — according to both Medicare and private health insurance data,” said a 2017 report by the U.S. Government Accountability Office. In a January memo, the National Association of Insurance Commissioners said that over the past decade, many states have reported issues with air ambulances no longer affiliated with a hospital and some that refuse to contract with insurers. The trend has resulted in significant outof-network bills for consumers, the report said. “Federal legislative action is necessary to give states the authority to address this issue,” the brief said. Missouri’s senators, Repub-
lican Roy Blunt and Democrat Claire McCaskill, were critical of the practice. “No family should be left financially devastated by a medical emergency,” Blunt said in an email. He said he’s reviewing the issue and legislation that has been introduced on the issue. “It breaks my heart that a family that’s done everything right — they have insurance, work hard, pay their bills — yet when the unthinkable happens and they need emergency care for a traumatic injury, their insurance covers just a fraction of the costs and they’re stuck paying the bill,” McCaskill said in an email. She said she is committed to fighting the issue. The 2017 GAO report said it’s unclear how widespread the problem is, so improvements need to be made in collecting consumer complaints. The Department of Transportation has authority to investigate unfair practices in the airline industry but said consumers may not know that air ambulances are included in its oversight. It’s been a more than a year since Ben’s accident. Fortunately, he’s a healthy 8-year-old boy who has had no lasting effects from his injuries. He’s now in second grade and likes to skateboard and jump on his backyard trampoline. He thinks he wants to be a teacher when he grows up. “At the end of the day, for me, the important thing is that my son is OK. I can’t afford it, but I can do a payment plan until I’m 200,” Millheim said. “Money is never more important than family. We’ll figure it out one way or another.” Samantha Liss • 314-340-8017 @samanthann on Twitter sliss@post-dispatch.com
S E RV I N G T H E P U B L I C S I N C E 1 878 • W I N N E R O F 1 8 P U L I TZ E R P R I Z E S
MONDAY • 04.23.2018 • $2.00
4 dead in Waffle House shooting
SOME MISSOURIANS’ BILLS:
$51,099 $32,445 $35,672 $27,000
MANY SNAGGED IN AIRLIFT LOOPHOLE
Gunman ‘all business’ Past includes multiple run-ins with law, probable mental issues Manhunt continues Suspect lives near restaurant in Nashville, was spotted on road
Reinking Authorities had seized guns in past
Shaw Wrestled gun away from shooter
BY SHEILA BURKE Associated Press
NASHVILLE, TENN. • A nearly na-
ked gunman wearing only a green jacket and brandishing an assault rifle stormed a Waffle House restaurant in Nashville early Sunday, fatally shooting four people before a customer rushed him and wrestled the weapon away. Authorities were searching for the suspect, Travis Reinking, 29, who they said drove to the busy restaurant and killed two people in the parking lot before entering and continuing to fire. When his AR-15 rifle either jammed or the clip was empty, the customer disarmed him in a scuffle. Four people were also wounded be-
NIKOS FRAZIER • nfrazier@post-dispatch.com
John Allen (center) prays with his wife, Jennifer, and sons Austin (left), 13, and Ethan, 6, before dinner on Tuesday at their Warrenton family home. John was airlifted from a Cape Girardeau, Mo., hospital to SSM Health St. Joseph Hospital-Lake Saint Louis in 2016 during a family trip. They received a bill for more than $51,000 for the air transport, which their insurer refused to pay.
Numerous patients in region report being burdened by huge air ambulance bills only partly covered by insurance — or not at all BY SAMANTHA LISS St. Louis Post-Dispatch
Dan Millheim, meet Dee Goodin. And while you’re at it, say hello to John and Jennifer Allen, Tom Seeger and at least 10 other Missourians who are facing hefty bills for air-ambulance service. After the Post-Dispatch last month reported how Millheim was stuck with a $32,000 bill from the transport of his gravely injured son to a hospital, the newspaper heard from other people in similar straits. As in the Millheim case, insurers covered just a fraction of total transport costs because the air ambulances were deemed “out-of-network.” Millheim’s son, Ben, fell in 2016 during a camping trip in rural Missouri and fractured his skull. Because the boy was
unconscious, bleeding from his ears and having seizures, he was taken by Air Evac Lifeteam to a St. Louis hospital. The Millheims’ insurer, Anthem Blue Cross Blue Shield, paid $11,787 of the $44,232 bill, leaving the family with a balance of $32,445. The insurer denied the rest of the Millheim claim, even though a medical professional made the decision to call an air ambulance. Others who now face massive bills tell a similar story — and are now asking why there are no safeguards to reduce the financial blow. • Dee Goodin, 31, says he’s “lost all hope” of getting Air Evac to forgive the $36,000 the company says he still owes. Goodin, who operates a lodge and camping resort along the Black River, See BILLS • Page A6
BY KAREN DEYOUNG Washington Post
WASHINGTON • The last time they
BY KURT ERICKSON St. Louis Post-Dispatch
See MACRON • Page A7
JEFFERSON CITY • It’s been eight months since Missouri Gov. Eric Greitens halted the execution of a man convicted of murdering a former PostDispatch reporter. In doing so, Greitens appointed a special panel of former judges to review whether Marcellus Williams should be granted clemency in the case involving the death in 1998 of Lisha Gayle. For Williams, time has stopped in his death row cell in a prison 75 miles south of the site of the University City murder scene. “He’s just Marcellus. He’s living day by day. He thinks whatever happens is God’s will,” Williams’ attorney Kent Gipson said. Williams was 29 when he was charged with murdering Gayle. At the
met face to face, at the United Nations in September, French President Emmanuel Macron was puzzled when President Donald Trump and his delegation seemed to have no agenda, carried no papers and took no notes. “It was like a good discussion with a buddy in a bar,” recalled a French official. “At the end, you don’t know exactly what it means.” Now that Trump has been in office longer, the official mused, “maybe the process is different.” At the very least, the agenda will be clear to both sides when Macron arrives here Monday for the first official state visit Trump has hosted for any leader. After their joint attack, with Britain, on Syrian President Bashar
60°/52° CHANCE OF SHOWERS
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Uptick in ‘red flags’ in wake of Parkland More threats reported at schools since attack
John Allen of Warrenton is shown unconscious in a hospital in 2016 in this photo provided by the Allen family. He went into cardiac arrest while on a trip to Poplar Bluff, Mo., in 2016 and was taken to a hospital, but then was airlifted to another hospital.
BY CHRISTINE BYERS St. Louis Post-Dispatch
Police were called to Northwest High School in Cedar Hill on March 7 after a student reported a classmate had opened a door and proclaimed there would be a shooting at the school. But the student in question explained to police that he had actually been showing his friend that the door was unlocked and that it was a security concern. He must have been overheard by someone who misunderstood and saw a threat where there was none. A month later, St. Charles County police questioned a student at Francis Howell Union High School after he allegedly threatened on social media to
Death row inmate convicted in former St. Louis reporter’s death awaits clemency review
Iran deal to be No. 1 issue when Macron and Trump meet
TODAY
See SHOOTING • Page A4
See THREATS • Page A4
Williams
Gayle
PUJOLS NEARS
3,000
time, he had been convicted of burglary and was later convicted of an unrelated armed robbery at a restaurant. While Williams awaits his fate in the Potosi Correctional Center, the panel of retired judges is in the midst of a rare review of his controversial case, one that could result in his avoiding lethal injection for the second time. In a recent interview, former U.S.
SPORTS • B1
See CLEMENCY • Page A4
Cardinals sweep Reds
A blow to Greitens’ ambition
EPA honors Cards for waste efforts
• A3
Starter Miles Mikolas gets his third win
A limited schedule for Loop Trolley
• A5
SPORTS • B1
Reunion leads to incest, murder
• A2
1 M • A10
Vol. 140, No. 113 ©2018
FROM A1
A6 • ST. LOUIS POST-DISPATCH
M 1 • MONDAY • 04.23.2018
Consumers urged to ask lawmakers to fix flaw in system BILLS • FROM A1
flipped his Jeep in Reynolds County late last year, fracturing multiple vertebrae in his back. He was airlifted to Mercy Hospital in Creve Coeur. Air Evac billed Goodin’s insurer, Anthem Blue Cross Blue Shield, $47,560. The insurer paid nearly $12,000, leaving Goodin on the hook for the remainder of the bill, which totals $35,672, according to documents Goodin provided to the Post-Dispatch. Air Evac is considered out-of-network, which means Anthem and Air Evac have not agreed to pricing terms, leaving patients like Goodin stuck in the middle. “I’m going to be honest, I am not entertaining their calls. I’m not interested in taking on a bunch of debt,” he said, noting it’s almost as much as the remainder of his mortgage. “I just feel like it’s a failure of the industry and, ultimately, it’s leaving the insured to hang in the wind.” • Jennifer and John Allen of Warrenton owe about $51,000 after John was airlifted from a Cape Girardeau hospital to SSM Health St. Joseph Hospital-Lake Saint Louis. Anthem denied the payment entirely. While on a trip in Poplar Bluff, John Allen, 47, couldn’t breathe — he has chronic obstructive pulmonary disease and emphysema and went into cardiac arrest. He was taken to a hospital in Cape Girardeau, then transported by air ambulance to the St. Charles County hospital, where his specialists are located. Anthem refused to pay because the air ambulance flew by a hospital that was closer to their original location. “In these cases you should be taken to the closest hospital that is able to give you the care you need to reduce your risk. We do not see that you were taken to the nearest appropriate hospital. For this reason we believe that air ambulance transport was not medically necessary for you,” according to a denial letter that was sent to the Allens. Jennifer Allen, 36, is an assistant office manager and her husband is a mechanic. They are currently working their way through the appeals process with Anthem. They are willing to set up a payment plan, but are hoping Anthem will pay a portion. • Tom Seeger owes slightly more than $27,000 after breaking three ribs and bruising his lung after a 14-foot fall while attempting to fix a zipline on his rural property. He made it to a nearby hospital; it had him airlifted to Mercy in Creve Coeur. Anthem paid part of the bill but left him owing about $22,000, which was turned over to a collection agency in 2016. The debt has since accumulated interest and Seeger now owes slightly more than $27,000, according to documents he provided to the Post-Dispatch. “I’ve refused to pay them and I told them to sue me,” said Seeger, owner of Seeger Toyota. “I think there’s a racket going on.” Similar stories about patients stuck with high air-ambulance bills have been relayed to the Missouri attorney general’s office. The attorney general’s office has logged and investigated 10 consumer complaints from consumers since 2016, according to a records request submitted by the Post-Dispatch. The attorney general’s office did not have a comment about overall findings, which include allegations against multiple air ambulances including Arch Air Medical Services, Air Evac Lifeteam and Survival Flight. In one instance, a parent, whose identification has been withheld by the attorney general’s office, said that after their child was born prematurely he was airlifted by Arch Air to a hospital that could care for him. “This company is taking massive financial advantage of Missourians at their most critical time of need; by refusing to partner with insurance companies and sticking families with untenable bills,” according to one complaint on file. A different parent in a similar situation also filed a complaint about Arch Air, alleging the company sent a nearly $43,000 bill to collections. In this case, a newborn was experiencing stomach issues, which needed the attention of specialists in St. Louis. After the insurance paid more than $12,000, the family was left with a nearly $43,000 bill. “We have been turned over to a collection agency for the remaining $42,505,” the complaint states. “We tried to arrange payments with Arch Air but they were unaffordable, wanting $300 to $400 a month.”
SEARCH FOR SOLUTIONS Because of the way private health insurance operates, there’s no marketplace solution to the problem of excess billing if air-ambulance companies are unwilling or unable to negotiate rates with insurers and insurers refuse to pay for out-of-network services. That points to a need for legislation, say some health care policy experts. “Without regulatory limits, there may be nothing to stop air ambulance providers from price gouging and balance billing in this way,” said Erin Fuse Brown, associate professor of law at Georgia State University. The Post-Dispatch story about the Millheims prompted state Sen. Jill Schupp, D-Creve Coeur, to send letters to various state departments and meet with representatives of the Missouri Department of Insurance to discuss her concerns. Schupp also is working to pass legislation aimed at protecting consumers from surprise bills after emergencies; however, due to the way air ambulances are regulated, changes to state law would likely prove ineffective in protecting consumers from these types of air ambulance bills. “People don’t stop and say to each doctor that sees them (in an emergency), ‘Oh, by the way, are you an innetwork doctor?’” she said. Schupp said her legislation would attempt to protect patients from balance billing, which is when patients are billed for the difference between what an out-of-network provider charges and what the insurance company actually pays. In some cases, patients can go to an in-network hospital but be treated by a doctor that’s out-of-network, exposing them to more financial risk. Schupp’s bill would apply only in emergency situations. “The bill puts together a framework for making sure that the provider and the insurance know how to work out the payment and the patient is excluded,” Schupp said. However, because air ambulance services are federally regulated, she said, it’s unlikely her bill would protect consumers for balance billing in these situations. The issue has prompted Dr. Randall Williams, director of Missouri’s Department of Health and Senior Services, to call on his colleagues at the Department of Social Services and Department of Insurance to see what role, if any, state agencies can play in assisting families. He has had at least one meeting with various department heads including Steve Corsi of the Department of Social Services and Chlora Lindley-Myers of the Department of Insurance. Those representing the insurance industry say the flaw
PHOTOS BY NIKOS FRAZIER • nfrazier@post-dispatch.com
John Allen (right) tosses a ball to his son, Ethan, 6, as Austin, 13, waits in the outfield on Tuesday at their Warrenton home. John was airlifted from a Cape Girardeau, Mo., hospital to SSM Health St. Joseph Hospital-Lake Saint Louis in 2016 while the family was on a trip to Poplar Bluff, Mo., Payment for the bill, which totaled more than $51,000, was denied by their insurance company.
in the system is that there is no incentive for air ambulance companies to join a network. “This is what happens when an insurance provider is not able to negotiate those lower prices for you. You as a consumer are left to see the entire impact of the out-ofcontrol prices,” Kristine Grow, spokeswoman for America’s Health Insurance Plans, told the Post-Dispatch. Critics say failure to reach a pricing deal puts Americans in precarious situations. The median household income was $57,617 in 2016, according to the U.S. Census Bureau. The industry across the U.S. is dominated by three forprofit air ambulance companies, which control 66 percent of the market, according to a 2017 report from the U.S. Government Accountability Office, citing figures from 2015. The state’s two largest insurance companies — Anthem Blue Cross Blue Shield and UnitedHealth — do not have any in-network air ambulances through direct contracts. However, in some cases hospitals have pricing contracts with the air ambulances, by extension giving UnitedHealth and Anthem pricing deals because of their arrangements with the hospitals. Faced with similar consumer complaints, North Dakota took steps last year to inform patients about which air ambulance companies are in-network with the state’s largest insurance providers. Providers are required to share the information with patients, and the state’s insurance commissioner also maintains a consumer-friendly guide that identifies carriers that are part of a network and those that are not. Consumer advocates in Missouri say patients need to call on legislators to demand action. “If you have consumers calling you, they need to call their legislators. This is a systemic issue,” said Ryan Barker, vice president of health policy with the Missouri Foundation for Health.
MEDICAL COSTS Reporter Samantha Liss is focusing on medical costs. Do you have a bill that you consider excessive? You can contact her at sliss@post-dispatch.com for possible use in a future story.
Jennifer Allen and her husband, John Allen, shown in their Warrenton home on Tuesday, were billed at least $51,000 after John Allen was airlifted from a Cape Girardeau, Mo., hospital to one in St. Charles County. They are appealing to their insurer, Anthem, in hopes that the company will agree to pay a portion of the bill.
“If you have consumers calling you, they need to call their legislators. This is a systemic issue.” Ryan Barker, vice president of health policy with the Missouri Foundation for Health
Samantha Liss • 314-340-8017 @samanthann on Twitter sliss@post-dispatch.com
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TUESDAY • 05.01.2018 • $2.00
PAYMENT MAKER IDENTIFIED Defense claims • Missouri Times owner gave lawyer $50,000 Coming soon • Ruling on inclusion of accuser’s testimony Panel report • Woman’s testimony again called credible Page A4
BY JOEL CURRIER, ROBERT PATRICK AND JACK SUNTRUP St. Louis Post-Dispatch
LAURIE SKRIVAN • lskrivan@post-dispatch.com
Attorney Albert Watkins arrives for his deposition on Monday at the Carnahan Courthouse downtown.
ST. LOUIS • A defense lawyer for Gov. Eric Greitens said in court Monday that Scott Faughn, an owner of the Missouri Times, gave $50,000 cash to lawyer Albert Watkins, who represents the exhusband of the woman who accused the governor of taking a partially nude photo of her in 2015. Faughn, a frequent critic of the governor, said
in a 16-minute broadcast on social media Monday that he had hired Watkins while he was conducting “research” on Greitens for a book he was planning. He did not address whether he gave Watkins $50,000 in cash or who was the original source of the money. Faughn did not respond to inquiries from the Post-Dispatch seeking more information about the payment. See GREITENS • Page A4
Victim was celebrating his birthday
Faughn Greitens critic, owner of Missouri Times
McCaskill starts inquiry into aircraft ambulances and insurers BY SAMANTHA LISS St. Louis Post-Dispatch
Sen. Claire McCaskill is seeking answers from air ambulance providers and insurance companies over significant bills Missouri families have faced after medical emergencies. She’s asking nine different companies for information, including their billing practices and a list of air ambulances that operate in-network, according to the letters provided to the Post-Dispatch. She’s asking the companies to respond by May 21. “A recent series of articles by the St. Louis Post-Dispatch highlighted the costs being passed along to consumers through the practice of balance billing by providers of air ambulance service,” McCaskill writes. In March, the Post-Dispatch wrote about a boy who fractured his skull in See MCCASKILL • Page A5
CHRISTIAN GOODEN • cgooden@post-dispatch.com
A sign on the entrance to Ballpark Village, seen on Monday, indicates the prohibition of firearms inside the complex. The day before, a shooting on the rooftop of the Budweiser Brew House left one person dead and another injured.
Hall No indication he knew the shooter, police say
Man fatally shot at Ballpark Village after scuffle was father, newlywed
BY CHRISTINE BYERS St. Louis Post-Dispatch
ST. LOUIS • The man who was shot
to death during a party on a rooftop at Ballpark Village on Sunday night was a father of two girls and a newlywed who was celebrating his birthday. Police identified the dead man as Corey Hall, 38, of north St. Louis County. He was with a friend at the EAT. DRINK.
Israel says secret files prove Iran lied about its nuclear program
CHILL. event at the Budweiser Brew House across the street from the stadium about 8 p.m. Sunday when a scuffle broke out. Witnesses told police that the shooter and a friend of Hall’s got into a shoving match after one bumped into the other, according to police sources. The shooter fell at one point, according to the See BALLPARK • Page A4
BY JOSEF FEDERMAN Associated Press
JERUSALEM • Israel’s prime minister
try, rising nine cents to $2.55 a gallon for regular unleaded gas, the AAA said Monday. In Illinois, the average cost for a gallon of unleaded gas is $2.87, according to the AAA. “This will be the most expensive driving season since 2014,” said Tom Kloza,
on Monday unveiled what he said was a “half ton” of Iranian nuclear documents collected by Israeli intelligence, claiming it proved that Iranian leaders covered up a nuclear weapons program before signing a deal with world powers in 2015. In a speech delivered in English and relying on his trademark use of visual aids, Prime Minister Benjamin Netanyahu said the material showed that
See GAS • Page A5
See ISRAEL • Page A7
Gas prices may make driving season most expensive in years The U.S. daily national average for regular gasoline is now $2.81 per gallon. That’s up from about $2.39 per gallon a year ago, according to Oil Price Information Service. And across the U.S., 13 percent of gas stations are charging $3 per gallon or more, AAA said last week. Over the past week, Missouri had the largest weekly gas increase in the coun-
BY ALEX VEIGA AP Business Writer
Get ready for a little bit more pain at the pump this summer. Crude oil prices are at the highest level in more than three years and are expected to climb higher, pushing up gasoline prices along the way.
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05.01.2018 • Tuesday • M 1 ST. LOUIS POST-DISPATCH • A5 NEWS
PRIOR TIMOTHY HORNER
St. Louis Priory’s co-founder, first headmaster dies BY KRISTEN TAKETA St. Louis Post-Dispatch
Sixty-three years ago, a group of St. Louis Catholics asked the Benedictine Ampleforth Abbey of Yorkshire, England, to bring them a Catholic all-boys, college preparatory school that would be competitive enough to send boys to the country’s most selective colleges. Prior Timothy Horner was one of three Ampleforth monks chosen for the mission. When the Rev. Horner arrived in the U.S., he drove Horner solo up and down the East Coast visiting the best schools to research what colleges wanted to see in high school graduates. The Rev. Horner co-founded St. Louis Priory School and became its first headmaster. He died Friday at St. Louis Abbey
at age 97. “He wasn’t afraid of doing lots of hard work and of all sorts of discomfort in serving people, in making the school known,” said Abbot Thomas Frerking. The Rev. Horner decided on three basic ingredients that could make the school successful — small class sizes, high standards and close relationships with parents, said the Rev. Laurence Kriegshauser of St. Louis Abbey, the community of Benedictine monks that the Rev. Horner and his brother monks founded. Those three principles still guide the school’s approach to education. Each of the three founding monks was chosen for this mission for a specific role. The Rev. Horner was picked to become Priory’s first headmaster because he was a scholarly man and had taught before. The Rev. Horner was fond of the classics, having studied them at Oxford University before and after a six-year stint in the British Army. His favorite books included
the likes of “The Odyssey” by Homer, “Agamemnon” by Aeschylus, “Aeneid” by Virgil and “Republic” by Plato. He was not easy on his students. One of his students once tried to play a prank, Kriegshauser said. The Rev. Horner responded by taking the carburetor out of the student’s car. “He certainly challenged them to make the most of their ability. He did not tolerate fools,” said St. Louis Abbey’s Prior Paul Kidner. “He was pretty demanding, but that demand usually paid off and the boys achieved to the best of their ability.” The leaders of St. Louis Priory say the Rev. Horner’s two decades of leadership paid off. Today, the school enrolls about 410 students in grades 7-12 at an annual tuition of $24,125. The school provides tuition help to about 30 percent of them. More than two dozen of its 62 graduates last year went to some of the country’s most selective colleges. There are more than 2,500 alumni.
The Rev. Horner also leaves behind two scholarly works: a translation of the Rule of St. Benedict called “RB 1980” and one of the most widely used editions today, and a history of Priory’s founding, called “In Good Soil.” It is custom for the monks to hold an all-night vigil of silent prayer for their deceased brother before the funeral. From about 6 p.m. Friday to about 6 a.m. Saturday, the St. Louis Abbey monks will take shifts keeping watch over the Rev. Horner’s body through the night. The passage of night into day is important and symbolizes Jesus’ rising from the dead, Frerking said. The vigil will be followed by a funeral Mass at 10 a.m., then a burial and a reception. All events are public and will take place at St. Louis Abbey, 500 South Mason Road. Kristen Taketa @Kristen_Taketa on Twitter ktaketa@post-dispatch.com
McCaskill cites Post-Dispatch reports in launching her inquiry MCCASKILL • FROM A1
rural Missouri in 2016. Ben Millheim, who is now 8, survived but his family is stuck with a bill of more than $32,000. The Post-Dispatch heard from more Missourians with hefty air ambulance bills after it published the Millheims’ story. In almost all the cases reported to the Post-Dispatch, the patient was insured but the air ambulance that transported the patient was out of network, which means the air ambulance provider and the insurance company had not agreed to pricing terms, leaving patients stuck in the middle. “This financial burden being placed on insured consumers appears to be driven in large part by the inability or unwillingness of some private health insurance providers and air ambulance providers to agree on terms for reimbursement,” McCaskill writes. To better understand industry practices and how they affect Missourians, McCaskill, in letters dated April 30, has asked air ambulance companies for: • A complete list of locations in Missouri, including the number and type of aircraft per location. • The number of flights operated in Missouri in 2017, including those by a contractor. • A list of health insurance providers that are considered in-network. • A summary of Missouri patients who received a bill in 2017 that was denied payment in whole or in part by an insurance provider; total number of bills issued, average charge per bill and the number of bills that remain unpaid. • Any documentation provided to patients who wish to challenge or appeal a charge. • Any documentation provided to patients informing them how to file a complaint
MEDICAL COSTS Reporter Samantha Liss is focusing on medical costs. Do you have a bill that you consider excessive? You can contact her at sliss@post-dispatch.com for possible use in a future story.
related to air ambulance service or billing with state and federal regulators. McCaskill has asked similar questions of the insurance companies, including: • A list of air ambulances that are in-network. • Any documents that detail policies regarding air ambulance coverage, including any limitations on coverage. • A summary of how many air ambulance claims were processed in 2017, and a breakdown of how many were denied in part or in whole. • Documentation provided to patients who wish to appeal or challenge a claim. • Documentation provided to patients informing them how to file a complaint with state or federal regulators. McCaskill sent letters to the leaders of Aetna, Air Evac Lifeteam, Air Methods, Anthem Blue Cross Blue Shield, Blue Cross Blue Shield of Kansas City, Cigna, Humana, LifeFlight and UnitedHealth Group. The state of Missouri spent $3.6 million on 2,897 air ambulance transports for its Medicaid recipients in fiscal year 2016.
global head of energy analysis for Oil Price Information Service. The price of U.S. crude oil has been on a mostly steady incline since last June and last week hit $68.64, the highest since December 2014. Benchmark U.S. crude closed Monday at $68.57. Oil prices near $70 shouldn’t put the brakes on economic growth, however. While they’re boosting costs for some sectors of the economy, the energy sector and related industries have more money to spend on equipment and workers. But higher oil prices are certainly an inconvenience for drivers. “The good news is, both at the global level and the U.S. level, this is occurring at a time when growth is fairly robust,” said Nariman Behravesh, chief economist at IHS Markit. “But consumers as a whole will be hurt, mostly because gasoline prices are going up.” Kevin Lanke, a motion picture lighting technician in Redondo Beach, Calif., says he’s now paying about $3.39 per gallon to fill up the 25-gallon tank in his 2000 Land Cruiser SUV. That’s about 20 cents more per gallon than a couple of months ago. “I would fill up my car and it would be $52 or $53,” said Lanke, 51. “Now it’s in the mid $60s for the same amount of gas.” Several factors have helped drive oil prices higher. Global economic growth has driven up demand for oil. Production cutbacks initiated by OPEC last year have helped whittle down oil supplies. In the U.S., oil supplies were running 1.1 million barrels lower at the start of this summer’s driving season, which runs from April through September, than a year ago, according to the U.S. Energy Information Administration. That has amplified the increase in gas prices typically seen this time of year. Pump prices normally rise as demand increases from families going on vacation and taking to the highways on road trips. Already, U.S. consumer demand for gasoline hit a record high for the month of April, according to the EIA. Drivers in Western states such as California, Oregon, Washington, as well as Alaska, Hawaii, Connecticut and Pennsylvania, are paying the most at the pump. The average retail price in those states is running from $2.95 to $3.61 per gallon. Still, prices remain well off from 2008,
OPENING UP REGULATION On Friday, the U.S. House passed a deal that reauthorizes the Federal Aviation Administration, which provides funding for five years. A section of the bill could change the way air ambulances are regulated. Right now, air ambulances are considered air carriers under federal law. And states are barred from regulating the price or routes of air carriers, which includes air ambulances, under the Airline Deregulation Act of 1978.
Because of this, states cannot regulate air ambulance prices, prohibit balance billing or make prices transparent, according to Erin C. Fuse Brown, a health law expert at Georgia State University. The language in the FAA reauthorization bill would require air ambulance providers to clearly separate the charges associated with the flight versus the medical services provided on board. That would allow states to regulate the prices and services of the medical part of the flight. “The bill is promising because it opens the door to state regulation of part of the air ambulance bill. But it remains to be seen how it will play out in practice,” Brown said. Representatives from the air ambulance industry say it would set up a situation where, “An insurer would say, ‘We’re not going to cover the transport but we’ll cover the care,’” said Carter Johnson, spokesman for SOAR, a group that supports the air medical evacuation industry. It would allow each state to craft different laws and regulations, which would be difficult for air ambulance companies to navigate because the aircraft cross borders frequently, Johnson said. Kurt Erickson and Jack Suntrup of the Post-Dispatch contributed to this report. Samantha Liss • 314-340-8017 @samanthann on Twitter sliss@post-dispatch.com
STATE ZEROS IN One state legislator said efforts to fix the air ambulance billing issues are alive in the Capitol. The Senate recently passed a bill that aims to protect patients from surprise bills when they unexpectedly receive out-ofnetwork care. Senate Insurance Committee chairman
Crude oil prices have climbed since June GAS • FROM A1
Paul Wieland, R-Imperial, told reporters Thursday during a news conference that he’s hoping to add an amendment that would tackle out-of-network air ambulance issues, too. The House is expected to take up the bill this week, but Wieland admits it is a difficult issue to solve. “But that’s a lot stickier of an issue because we’re talking about a lot bigger dollars and there’s less incentive for the airevac companies to come to the table. Because right now they can charge what they want and they’re protected under federal legislation to a certain extent,” Wieland said Thursday. On the same day Wieland made his comments, one air ambulance company, O’Fallon-based Air Evac Lifeteam, hired a new team of lobbyists, from Gamble and Schlemeier, according to records from the Missouri Ethics Commission.
when crude oil prices jumped above $130 per barrel and average retail gas prices surged to an all-time high of $4.11 per gallon. “People forget very, very quickly,” Kloza said, noting that the average U.S. gasoline price remains well below where they stood five years ago at $3.60 per gallon. “We’re seeing a higher price environment ... but I don’t think we’re going to look at really apocalyptic numbers,” he said. The EIA projects that the U.S. retail price for regular gasoline will average $2.74 per gallon this summer, up from an average of $2.41 per gallon a year earlier. Gas prices usually rise each spring through Memorial Day and slowly decline as the summer goes along. For 2018, the agency expects that the national retail price for all grades of gasoline will average $2.76 a gallon. That would translate into an additional $190 spent on fuel by the average U.S. household this year compared to last, the agency said. “At the higher income levels, this won’t really have much of an effect,” Behravesh said. “But it’s a bigger deal for lower-income families, because a bigger share of their budgets goes to things like gasoline.” In broader economic terms, the rise in oil and gasoline prices will help crude producers in states such as Texas and North Dakota and will likely boost capital spending industrywide. Spending by oil companies fell sharply as oil plunged below $30 a barrel in 2016, dragging on U.S. economic growth. Industries that rely heavily on fuel, such as shipping companies, airlines, vehicle fleet operators and other transportation companies, are seeing rising costs, which eventually will be passed on to consumers. Diesel fuel hit its highest national average price in more than three years over the weekend at about $3.06 per gallon. American Airlines said it spent $412 million more on fuel in the recent first quarter than in the year-ago period. At current levels, U.S. crude oil prices won’t noticeably hamper the economy, said Behravesh. “You would have to get up into the $90$100 range for it to really have a big impact on growth,” he said. “At these levels, it may shave off a tenth of a percentage point off global growth.” The Post-Dispatch contributed to this report.
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GROWING BACKLASH ATTORNEY GENERAL
NATIONAL ENQUIRER
MANAFORT TRIAL
SENATE RACE
SESSIONS FIRES BACK AT TRUMP
PUBLISHER CUTS IMMUNITY DEAL
ONE HOLDOUT AMONG JURORS
McCASKILL, HAWLEY WALK A TIGHTROPE
After blistering criticism from President Donald Trump, Attorney General Jeff Sessions vows his Justice Department won’t be influenced by politics
Tabloid executive David Pecker reportedly receives immunity in exchange for information about hush-money payments made on behalf of Trump
Sole juror prevented Trump’s former campaign chairman from conviction on all 18 counts of financial fraud, according to another member of the jury
Locked in a tight battle for a U.S. Senate seat, Claire McCaskill and Josh Hawley have steered clear of this week’s turmoil circling the president
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Hawley to investigate clergy sex abuse crimes
Anthem to cover air ambulance services
SEEING THE LIGHT
BY JACK SUNTRUP AND NASSIM BENCHAABANE St. Louis Post-Dispatch
BY BLYTHE BERNHARD St. Louis Post-Dispatch
After reports of hefty medical bills and pressure from lawmakers, Anthem health insurance now covers emergency air ambulance services from the two main companies that airlift injured and sick people to St. Louis hospitals. An agreement between Anthem and Air Methods, owners of ARCH Air Medical Service in St. Louis, covers plan holders in Missouri, Indiana, Kentucky, Ohio and Wisconsin and became effective Aug. 15. Anthem has also partnered with O’Fallon, Mo.based Air Evac Lifeteam for customers in Missouri and Kentucky, effective July 1. Before the agreements, Anthem Blue Cross Blue Shield of Missouri, one of the state’s largest insurers, had no contracts with in-network air ambulance providers. That affected people such as Dan and Melissa Millheim, who received a bill of more than $32,000 in 2016 after their young son, Ben, fractured his skull in a fall while camping in rural Missouri. The Millheims were insured by Anthem Blue Cross Blue Shield, which paid $11,787 of the $44,232 total for the airlift from Air Evac Lifeteam to a St. Louis hospital. Air Evac Lifeteam operates 13 helicopters and one airplane in Missouri and 12 helicopters in Southern Illinois, according to CEO Seth Myers. Steve Gorman, Air Methods CEO, said the Colorado-based company will work with other insurance companies to improve coverage of air ambulance transport. The company airlifts 70,000 people each year to hospitals nationwide. A company
JEFFERSON CITY • Missouri Attor-
ney General Josh Hawley said Thursday that he would launch an investigation into sex crimes within the Roman Catholic Church, adding that the Archdiocese of St. Louis had offered to open its files to his office. At a news conference shortly after Hawley’s announcement, St. Louis Archbishop Robert Carlson promised Hawley’s office would have “unfettered” access to archdiocese records. “Anything that we have we will turn over,” Carlson said. Hawley’s announcement came after survivors of clergy sexual abuse and their advocates protested outside his St. Louis office on Wednesday demanding that he launch a statewide investigation. It also came a week after the release of grand jury investigation in Pennsylvania that uncovered the widespread abuse of more than 1,000 children by more than 300 priests over a period of 70 years. Hawley, a Republican who is running for U.S. Senate this year, said on Thursday that while prosecuting and subpoena authority rested with local law enforcement, his office would still investigate alleged crimes, publish a public report and refer credible cases to local prosecutors. “While my office does not have jurisdiction at the present time to prosecute any criminal acts of this nature, or again to issue subpoenas to investigate it, it would be possible to conduct a thorough and robust investigation of potential clergy abuse if the various dioceses were willing to cooperate,” Hawley told reporters.
See CLERGY • Page A4
LAURIE SKRIVAN • lskrivan@post-dispatch.com
Nigel DeLuca with Local 6 stagehands reaches to place one of the new LED bulbs on a chandelier on Thursday during the bi-annual cleaning and bulb replacement of the four chandeliers in the grand foyer of Powell Hall. Earlier this week, each chandelier was lowered by a hand crank and crews spent several days removing the 599 crystal pieces. A crew replaced 102 bulbs per chandelier with LED bulbs for the first time. The conversion is part of a project to replace all the fixtures in the symphony hall with LED bulbs.
Panel backs tax support for project at I-170 and Olive in University City BY NASSIM BENCHAABANE St. Louis Post-Dispatch
A University City commission voted Thursday night for a plan to provide up to $70 million in tax assistance for a $190 million retail-anchored development at Interstate 170 and Olive Boulevard. The 10-2 vote from the Tax Increment Financing Commission came after a fourth round of public comment and with the city manager and mayor recommending approval. The commission’s vote followed more than two hours of
TODAY
comments from supporters and opponents of the project. The city council will have to grant final approval. TIFs freeze property assessments and let the owners use the increase in taxes from development to help finance their project. The TIF University City is considering could be worth $70 million over 20 years. The proposal, by Webster Grovesbased Novus Development, would require the buyout of dozens of homes in See TIF • Page A4
DeVos considers allowing schools to use federal funds to buy guns
CHANCE OF STORMS
WA S H I N GTO N • Education Secretary Betsy DeVos is considering whether states can use DeVos federal grant money to buy guns for schools, including potentially arming teachers, after receiving queries from Texas and Oklahoma, people familiar with the matter said. The idea drew swift criticism from Democrats, teachers unions, education
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ings. Texas and Oklahoma were seeking clarity on spending funds from Student Support and Academic Enrichment See SCHOOLS • Page A13
• A3
East St. Louis High bans outside snacks
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groups and gun control activists, who said the response to school shootings should be fewer guns, not more. But President Donald Trump and others have argued that arming teachers would “harden” schools and make them less likely targets for mass shoot-
BY LAURA MECKLER AND MORIAH BALINGI Washington Post
Eye exam may predict Alzheimer’s
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East St. Louis High School bans outside snacks BY MICHELE MUNZ St. Louis Post-Dispatch
Students at East St. Louis High School are no longer allowed to bring outside snacks into the school after a “banned substance” was brought onto campus through a snack on Tuesday. Officials would not say what the substance or snack was. “This action has been taken to ensure the safety and health of the overall student body,” the school said in a prepared statement. Families were given details
of the guidelines Wednesday. If snacks are discovered as students go through security, the students are given option of returning outside to consume the items or turning the food in to be claimed at the end of the day. The items are kept in a locked security office and labeled with the student’s name, school district spokeswoman Sydney Stigge-Kaufman said. Most of the items confiscated so far include chips, candy, snack cakes and soda, Stigge-Kaufman said. Lunches – such as dinner leftovers – will be allowed after
inspection. Stigge-Kaufman said that because 96 percent of students in the district are low-income, all students are provided a healthy breakfast and lunch at no charge through the federal Community Eligibility Provision program. Most students do not bring their lunches, she said. Students with special dietary or medical needs can meet with the school nurse to ensure they have access to items they may need to bring in, she added. While schools have reported enacting policies banning home-
made snacks for class parties and events because of concerns for students with allergies, storebought items with a list of ingredients usually get the OK. About six years ago, some Chicago public schools made waves when they banned homemade lunches because the lunches students were bringing were not healthy. Stigge-Kaufman said East St. Louis High School officials were concerned that even store-bought snacks might be tampered with, particularly if students opened them before
entering the building. A ban on all snacks also makes the inspections easier, she said. “We have over 1,200 students, and there are checkpoints they have to go through for other safety reasons,” she said. “If security has to decide if this snack vs. that snack is allowed, it just becomes too much. This just expedites the process.” Michele Munz • 314-340-8263 @michelemunz on Twitter mmunz@post-dispatch.com
Attorney general launches investigation into clergy sex crimes CLERGY • FROM A1
He said Carlson had sent a letter this week confirming that the Archdiocese of St. Louis “will open to my office their files and allow us to conduct a thorough, impartial review of potential clergy abuse.” Carlson said he reached out to Hawley’s office after the archdiocese received mail and phone calls from people urging him to invite an independent review. A few of those with concerns said they would withhold funding. “The majority of the people said, ‘Tell us what you’ve been doing and make sure it is not done by you but by an independent agency,’” the archbishop said. “And it is my feeling that the attorney general would be the appropriate agency to do this. Obviously it’s going to be at arm’s length. We’re going to have to meet and see what their protocols are going to be, but we’re looking forward to that process beginning.” Hawley said that he “would invite the state’s other dioceses to cooperate similarly with this office’s investigation, so that our report can be truly comprehensive and statewide.” Leslie Eidson, spokeswoman for the Springfield-Cape Girardeau Diocese, was not immediately available for comment on Thursday. The Springfield News-Leader reported last week on a couple who sued the diocese alleging that Troy Casteel, its director of family ministry, manipulated the couple during marital counseling between 2013 and 2017. The lawsuit alleges Casteel sexually abused the wife on diocese property, that the diocese was aware of the abuse and that the diocese provided Casteel “sanctuary.” Until 2015, Bishop James V. Johnston Jr. headed the Springfield diocese before departing for the Kansas City diocese. There Johnston replaced Bishop Robert W. Finn, who resigned after he was convicted of failing to report a priest’s sus-
ROBERT COHEN • rcohen@post-dispatch.com
St. Louis Archbishop Robert Carlson (at lectern) takes media questions Thursday at the Rigali Center about the archdiocese’s decision to open its files to an investigation into clergy sex crimes.
pected child abuse. Jack Smith, spokesman for the Diocese of Kansas City-St. Joseph, said the diocese had not received a formal request from Hawley but would cooperate with the review. Bishop W. Shawn McKnight of the Diocese of Jefferson City said in a letter to Hawley on Thursday that when he took over as bishop in February, the diocese hired an independent firm to review its files. He said that the review was completed in June, and that the diocese was preparing the release of a report. But, he said that it would “suspend” those efforts while Hawley launches his investigation. He said the diocese would welcome a “thorough review.” Carlson said he hoped Hawley’s investigation would “give confidence” to people in the Archdiocese of St. Louis. “We did this for one simple reason: the credibility of the archdiocese and the fact that several people reached out to
me and asked us to do it, and I thought it was a fair request,” he said. “And I’ve had it done it before.” In 2002 when he was in the diocese in Sioux Falls he invited the South Dakota attorney general to review diocese files. In St. Louis, a 2017 review of the archdiocese’s records by a retired FBI agent at Carlson’s request found no evidence of abuse, he said. Sandra Price, executive director of the archdiocese’s Office of Child and Youth Protection, said that 27 priests had been relieved of their duties. “We don’t have any priests serving in priestly ministry that have substantiated or credible allegations of abuse,” she said. “I can’t reiterate that enough.” Price said the archdiocese had a “very extensive” program to safeguard children and prevent abuse, with measures including training more than 100,000 clergy, staff and parents on how to recognize warning signs and report abuse, conducting and reviewing background checks,
auditing parishes and schools to make sure policies are being followed, and prohibiting adults from working alone with children. “Anyone who works with children may not ever be alone in private with a child,” Price said. “We train everyone on that from the janitors to the principals to the deacons and the priests. That is a very important rule for us.” Nicole Gorovsky, a former Missouri assistant attorney general, former federal prosecutor and private attorney who specializes in child sexual abuse cases, was among those at the protest on Wednesday. Gorovsky said that she was “cautiously optimistic” about the investigation. “It sounds very optimistic, but I am concerned that the archdiocese is the one providing the information as opposed to law enforcement aggressively seeking the information because that means the archdiocese gets to provide what they want to provide,” she said Thursday.
David G. Clohessy, the former head of Survivors Network of those Abused by Priets (SNAP), also said that he was hopeful about Hawley’s investigation but that he still worried that the archdiocese would withhold relevant information. “Law enforcement needs to use subpoena powers to get at all church abuse records,” he said. Hawley said he was unaware of any ongoing grand jury investigations headed by local prosecutors in the state. Susan Ryan, spokeswoman for St. Louis Circuit Attorney Kim Gardner, could not immediately be reached for comment on Thursday. The attorney general did not immediately provide a timeline on how long the investigation would last. He said a team of prosecutors would handle the investigation, and that Christine Krug, the director of his office’s public safety division and sexcrimes prosecutor, would lead the inquiry. Like Carlson, Hawley said the St. Louis Archdiocese did not place any limits on what materials his office could ask for “at this time.” “I’m confident that they want to cooperate,” Hawley said. “If there’s not cooperation, that will be public and made known.” In Illinois, Attorney General Lisa Madigan said her office had reviewed the Pennsylvania grand jury report and found it identified at least seven priests with connections to Illinois. She said that the Chicago Archdiocese had agreed to meet with her and that she planned to reach out to the other dioceses in the state and expected the bishops would cooperate. “The Catholic Church has a moral obligation to provide its parishioners and the public a complete and accurate accounting of all sexually inappropriate behavior involving priests in Illinois,” Madigan said. Jack Suntrup • 573-556-6184 @JackSuntrup on Twitter jsuntrup@post-dispatch.com
U. City panel backs plan for tax-supported development at I-170 and Olive TIF • FROM A1
University City’s predominantly African-American Third Ward. It also would displace some longtime businesses along Olive, known for the international flavor of its restaurants. ”I see the deterioration, but you have had years to fix it,” Marquis Govan, 15, a resident of the ward, told the commissioners. He said the development would continue a historic pattern of displacement of black neighborhoods instead of helping them. He said he feared his grandmother, 75, would be forced out of her home. “I oppose the TIF because my grandmother was red-lined into her house 50 years ago,” Marquis said, referring to the historic process of limiting where mi-
norities can live. “She wouldn’t be there if you hadn’t put her there in the first place. And now you have this plan with all these supporters who don’t live where I live, who don’t drink the same water I drink, who don’t breathe the same air I breathe … “I want investment in my neighborhood, but this isn’t the right type of investment,” he added But supporters say the TIF could capture an influx of new cash to be earmarked for improvements in the city’s northern neighborhoods, which have seen far less investment than other areas of the municipality. Kathy Straatman, 67, was one of several people who spoke Thursday in support of the development. Straatman, a Third Ward resident, said the project
would help residents by raising property values. “Me and my neighbors support the TIF because we recognize that bringing up the value of our homes is very important,” she said. “This will help us do that. It will help the whole city. Nicole Angeri, a 10-year resident of the ward, said she was willing to sacrifice living in the neighborhood to bring investment. “We need development, we need courage, and we need it to happen now,” Angeri said. Novus has hinted the development would be anchored by a Costco and surrounded by other retail, offices, apartments and a hotel. It needs the city’s blessing to help it acquire some 50 acres, including businesses and more than 60 homes at the interchange.
In a speech recommending the commission approve the TIF, City Manager Gregory Rose said the first $10 million in revenue from the project would be set aside for “improvements” in the ward and an additional $5 million set aside for Olive. Rose also said 90 percent of the owners of single-family homes in the footprint of the development had already agreed to be relocated. He promised the City Council would not use eminent domain to move unwilling homeowners out and said he would not recommend any caps to the amount of financial assistance the city would give to business owners on Olive to help them relocate. Rose also said the city would sue the developer if it did not hold up its part of the agreement.
Mayor Terry Crow said the city would put requirements for minority participation in the construction of the development and for employment at the retail businesses. “This project was never supposed to be about Novus, (Novus President) Jonathan Browne or Costco,” Crow said. “It was about stabilizing and increasing our tax base and it was about allocating funds to investment in the Third Ward to help our citizens.” Several people in opposition to the TIF held a protest before the meeting. It was led by state Sen. Maria Chapelle Nadal and Cori Bush, who unsuccessfully challenged U.S. Rep. William Lacy Clay in the Democrat primary earlier this month.
Anthem makes deal with two air ambulance companies ANTHEM • FROM A1
spokeswoman said she did not have patient numbers for ARCH Air Medical Service, which has a helipad base near Highway 40 (Interstate 64) and Jefferson Avenue in St. Louis. SSM Health Cardinal Glennon Children’s Hospital, where Ben was taken, said it received about 700 patients annually via air ambulances. Colin Drozdowski, senior vice president at Anthem, said in a statement that agreements with air ambulance companies created
“a simpler and more affordable health care experience for those we have the privilege to serve.” It’s unclear how the agreement will affect people with air ambulance memberships, which promise to cover additional outof-pocket expenses after a patient is airlifted. A lack of in-network air ambulance providers has left families with insurance bills of $27,000 to $51,000 after a family member was airlifted to a hospital, a PostDispatch investigation found. The agreements between Anthem and the air ambulance
companies “mean more patients will have access to these lifesaving services without having to worry if their insurer will cover the cost,” said Carter Johnson, a spokeswoman for Save Our Air Medical Resources, a consortium of patients’ groups and air ambulance providers. “Air medical providers are focused on taking patients out of the middle, so that they can focus on their recovery, which is why providers go in-network when they find good partners.” The group is critical of insurance providers and supports
federal legislation that would increase Medicare reimbursement for air ambulance services among other reforms. That proposed bill “addresses the root cause of the billing issue, the chronic underfunding of Medicare,” Johnson said. Sen. Claire McCaskill, D-Mo., has drafted separate legislation that would allow states to regulate the medical costs of air ambulances and called agreements between insurers and air ambulances “a step in the right direction.” “It’s absurd to expect consum-
ers to worry about price-shopping and in-network services when they need an air ambulance,” the senator said in a statement Thursday. “I strongly urge other air ambulance providers and health insurers to follow suit to make sure Missourians have affordable access to these lifesaving services without having to worry about an astronomical bill after the fact.” Blythe Bernhard • 314-340-8129 @blythebernhard on Twitter bbernhard@post-dispatch.com