Medicare Settlement Vote Delayed

After debating the matter in closed session for more than an hour, Ventura County supervisors Tuesday delayed a vote on a $15.3-million settlement proposal in the county’s Medicare fraud case.

The board voiced concern the U.S. attorney’s settlement would not include other outstanding audits by state and federal agencies. Those audits could cost the county millions of dollars more, officials said.

“With the [U.S. Health Care Financing Administration] investigations and everybody else, it would most likely be much more than $15.3 million,” Supervisor Frank Schillo said. “There’s nothing in writing that says all the issues will be resolved with his settlement.”

County Counsel James McBride said supervisors will continue the matter in closed session during next week’s meeting.

“The direction we gave him was that the settlement had to include those other issues,” Supervisor Kathy Long said after the closed meeting, attended by supervisors, McBride, Health Care Agency Director Pierre Durand and Deputy Director Mike Powers. “We’ll keep meeting until this is resolved.”

In the Medicare fraud case, U.S. attorneys allege that the county fraudulently overbilled the federal government by placing doctors’ names on insurance claim forms for work actually provided by social workers, nurses and psychologists.

The proposed settlement only addresses that issue. Supervisors, however, want the settlement to also include fines or reimbursements ordered by federal health care administration and the state attorney general.

For instance, health care administration officials claim the county’s mental health department violated federal organizational rules from April to December 1998. During those nine months, the county had merged its social services and mental-health departments, creating a 1,400-employee superagency.

Some county officials say that fine alone could cost the county an additional $12 million.

The failed superagency has become the worst political fiasco in county history, with federal and state agencies launching several investigations into the county’s mental health system.

On Tuesday, Supervisor John Flynn called upon the mental health board to help lift the county out of its turmoil. The citizens advisory board was created by state directive to oversee the local mental health system and make recommendations to supervisors.

Flynn wants the 13-member board to focus on helping the county develop programs for the mentally ill.

“The board is filled with talented individuals,” Flynn said. “I’d like to see the board become more influential on issues such as housing. And work with Dr. [David] Gudeman on a strategy to do that.”

That teamwork may not come so easy.

On Tuesday, some members of the Mental Health Board complained to supervisors that Gudeman had refused to work with them. Board Chairman John Chaudier said Gudeman was not forthcoming with changes he is making within the mental health system.

“We need a free, easy flow of information,” Chaudier told the board. “Information should be pushed at us, rather than us trying to pull the information out of them.”

Gudeman said he meets with board members twice a week.

“I have made a conscientious effort to share information,” Gudeman said. “A lot of the information I give them is limited because we’re in the middle of investigations. They may not fully appreciate the confidentiality requirements.”

Gudeman said he welcomed direction from Mental Health Board members.

“I appreciate Supervisor Flynn’s guidance,” Gudeman said. “He set a good tone for the ongoing relationship.”