County to Delve Into Medicare Fraud Case

While Ventura County supervisors are set to vote today on a $15.3-million settlement proposal in the county’s Medicare fraud case, officials are stepping up an internal investigation into who was responsible for the many years of faulty billing practices.

As part of the probe, county Chief Administrative Officer Lin Koester is scheduled to meet with former mental health Director Randy Feltman on Thursday. Feltman ran the department during most of the eight-year period during which the U.S. attorney’s office says the county fraudulently overbilled Medicare.

From 1990 to 1998, county doctors’ names and provider numbers were used on Medicare claims for services provided by social workers, psychologists and nurses, federal investigators say. A doctor’s name on an insurance form allows for a higher Medicare reimbursement rate.

The FBI is investigating whether officials deliberately broke the law when billing the federal government for the higher rate.

Koester declined to say Monday whether Feltman, who now runs CalWorks, the county’s welfare-to-work program, or any other official would be fired or placed on administrative leave pending the internal probe.

All five supervisors strongly oppose such sanctions during the investigations.

“I’m not prepared to start chopping heads until I have more answers,” Supervisor Judy Mikels said.

“He is innocent until proven guilty,” said Supervisor Kathy Long, referring to Feltman, a 26-year county employee.

Koester, however, said state law gives him the authority to terminate or place on leave a program director, such as Feltman, without the approval of the Board of Supervisors.

Human Resources Director Barbara Journet said employees, especially those with tenures as long as Feltman’s, are rarely fired. Feltman was hired in 1972 as a psychiatric social worker.

“A leave of absence would not be unusual at all under these circumstances,” Human Resources Director Barbara Journet said. “We have certainly put people on leave for much less.”

Feltman, 55, could not be reached for comment Monday, but he has said he was unaware that the billing practices were illegal.

The U.S. attorney’s office began its investigation in December, nine months after supervisors merged the county’s social services and mental health departments--a move federal agents said violated Medicare billing rules.

The failed merger touched off several state and federal audits, including the U.S. attorney’s probe. Federal investigators have tentatively agreed to settle that case for $15.3 million.

If supervisors OK the settlement today, the matter would be submitted to federal Judge J. Spencer Letts for final approval.

But not all supervisors are ready to agree to the settlement.

Supervisor Frank Schillo voiced concern that the settlement would not include other outstanding audits, such as a separate one by the U.S. Health Care Financing Administration. That agency is investigating whether the organization of the county’s mental health department complies with federal standards.

“That one could cost the county several more million,” Schillo said. “All this talk about a settlement is baloney. There’s no settlement until all agencies sign it. That has not happened.”