The state auditor released a report Tuesday detailing extravagant spending by EMSA that would upset the public.
The report also reviews allegations of billing errors and conflicts of interest.
EMSA's board of trustees requested this audit.
EMSA gets its money from Oklahomans who pay for ambulance coverage, but the state auditor said EMSA has created a culture of inappropriate spending.
State Auditor Gary Jones said EMSA's mindset is not in line with its own guidelines to spend money as carefully as executives would spend their own.
EMSA'S expenditures and reimbursements from January 2009 to June 2012 include: $35,190 on floral arrangements, $23,875 for an employee's wife to provide exercise classes for Oklahoma City employees, and $16,140 in charitable donations.
In those three years, the report says EMSA employees were reimbursed $321,818 for "questionable items" like large meals, sizeable tips, valet parking and room service.
CEO Stephen Williamson turned in receipts for almost that same total, all by himself.
He spent $316,000 on things like: two lifetime subscriptions to Sirius satellite radio at $399.99 each, spa bills totaling $905, a $669 hotel bill that did not included the room charge, and a $450 membership to the American Airlines Admiral's Club.
The state auditor says EMSA's unwarranted expenses "are the very thing that erode public trust, because they do nothing to promote accountability."
The report found billing errors, but the auditor doesn't believe they were intentional.
The auditor recommends EMSA put policies in place for purchasing, reimbursements and conflict of interest.
The 11-member board that governs EMSA released this statement:
"What we do with the information is the critical piece of the audit process and we will be committed to improving organizational practices. The quality of care delivered by our service to our citizens in the Tulsa and Oklahoma City areas is excellent and has never been called into question."
No one from EMSA would speak on camera Tuesday.
The board of trustees will be discussing the audit Wednesday at their regular 1 p.m. meeting, which is open
to the public.