Montgomery County Audit Finds Years of Lax Oversight in EMS Reimbursement Program

By Michael Phillips | Maryland Bay News

A new performance audit by the Montgomery County Office of the Inspector General is raising serious questions about fiscal oversight inside Montgomery County government—specifically within the Montgomery County Fire and Rescue Service’s handling of millions in emergency medical reimbursements.

The audit, released in mid-to-late December, examined the county’s Emergency Medical Services Transport (EMST) Reimbursement Program, a system created in 2013 to allow the county to bill insurance providers—not residents—for ambulance transports. While the program has helped fund equipment, training, and facilities for the county’s 19 independent volunteer fire and rescue departments, auditors found that key legal and financial safeguards were ignored for years.

Improper Payments, Weak Controls

According to the audit, the Montgomery County Fire and Rescue Service improperly distributed EMST funds to the Montgomery County Volunteer Fire-Rescue Association, a nonprofit advocacy and administrative body—not an eligible service provider under county law.

County code requires EMST funds to go directly to individual local fire and rescue departments. Despite that, auditors found that between fiscal years 2021 and 2025 alone, the association received $688,711 for expenses including data system upgrades, administrative support, training, and conferences.

The Inspector General found no legal basis for those payments and cited inconsistent tracking, poor documentation, and weak monitoring by MCFRS—conditions that increase the risk of waste, abuse, or fraud, even if no intentional misconduct was identified.

A Decade-Long Lapse

Perhaps most troubling is the duration of the problem. The improper distribution of funds dates back to 2014, spanning multiple administrations and budget cycles without detection or correction.

From a center-right perspective focused on fiscal responsibility, the finding highlights a familiar problem in large, one-party jurisdictions: expansive government programs paired with insufficient oversight. When rules are treated as optional or dismissed as “technicalities,” accountability erodes.

Officials Respond

County Chief Administrative Officer Richard Madaleno said the county will initiate a comprehensive financial audit and take appropriate corrective action, including potential recovery of improperly distributed funds.

County Executive Marc Elrich acknowledged the violation but described it as a “technicality,” arguing that the money ultimately supported volunteer fire and rescue services. Elrich suggested that the County Council could amend the law to permit such distributions in the future—or redirect funds properly to individual departments.

Still, Elrich also questioned how the violation went unnoticed for more than a decade, an issue the audit itself leaves unanswered.

Broader Warning Signs

Beyond the EMST issue, the Inspector General flagged additional concerns, including inconsistent purchasing card (P-Card) usage and failures by some local departments to follow county procurement rules. Auditors issued seven recommendations aimed at tightening internal controls, improving documentation, enforcing compliance, and reducing long-term exposure to waste or misuse.

While volunteer fire and rescue services remain widely respected and essential to Montgomery County’s public safety network, the audit underscores a key conservative principle: good intentions are no substitute for clear rules and disciplined oversight.

As the county moves to implement reforms, taxpayers—and insurance payers indirectly funding these programs—will be watching closely to see whether promised audits and accountability measures lead to real change, or whether this episode becomes just another example of bureaucratic mismanagement quietly papered over in Annapolis-adjacent government.