SOUTHERN CALIFORNIA / A news summary : The Regional Review / DEVELOPMENTS IN ORANGE, RIVERSIDE, SAN BERNARDINO AND VENTURA : Higher Reimbursement for Clinics Rejected

Federal authorities have disqualified 34 of Ventura County’s 43 health clinics from receiving a higher Medicare reimbursement rate, putting the county at risk of losing millions each year.

The action comes one month after the county agreed to pay $15.3 million as a result of the initial fallout from its failed mental health merger. The potential loss compounds the county’s fiscal problems, which could mean the end of crucial programs, including a county homeless shelter, and delay funding for a badly needed juvenile hall.

The county has appealed the clinic decision to the Department of Health and Human Services in Washington, and Supervisor John K. Flynn is seeking the help of top-ranking officials as far up the political ladder as the White House.

“I’ve reached the end of my rope,” Flynn said. “I’ve already been in touch with [Tipper] Gore’s chief of staff, explaining the problem.” Vice President Al Gore’s wife leads a national campaign to improve services to the mentally ill.

Ventura County’s latest problem centers on the Health Care Financing Administration contention that most of the county’s clinics operate independently from the Ventura County Medical Center and should not be billing Medicare at a higher hospital-based rate.

Federal officials contend that four-fifths of the clinics are too far--more than nine miles--from the medical center and therefore do not qualify for the hospital-based rate.

The county maintains that the clinics are outpatient satellites of the public hospital. That designation would qualify the county to receive about $2 million more each year in Medicare reimbursements than if all the clinics were considered free-standing.