2 Senators Make Plea to Protect Clinic Funds

California’s U.S. senators entered the fray over Ventura County’s distressed health system Tuesday by calling on federal officials to reconsider their decision to withhold millions of dollars in Medicare funding.

Sens. Barbara Boxer and Dianne Feinstein issued a joint statement in Washington, D.C., urging federal officials to adopt a 90-day “cooling off” period before deciding whether to penalize 34 of 43 county health clinics.

“The thousands of Medicare patients who benefit from the primary health-care services provided by county health clinics should not be penalized while these administrative problems are solved,” the Democrats said in a letter to U.S. Health and Human Services Secretary Donna Shalala.

In July, federal health care officials determined that most of the county’s clinics were not entitled to a hospital-based reimbursement rate, and since have been withholding thousands of dollars each month in Medicare money.

Although county attorneys previously appealed the decision to Shalala, they recently stayed the appeal for 60 days in hopes of working out the problem with the Health Care Financing Administration.

“We’re asking HCFA to respond in kind,” said Matthew Kagan, Boxer’s Southern California aide.

The senators want the federal government to hold off on further penalties for 90 days, during which local officials hope to convince the federal authorities to resume the Medicare reimbursements at the higher rate.

“The action would create a cooling off period, during which HCFA and [the county] could work together to resolve their disputes cooperatively,” Boxer and Feinstein wrote.

The Medicare payments would allow crucial health care services to continue at the county’s clinics, the letter said.

Supervisor John Flynn said he was pleased that the senators have joined the county’s battle to save Medicare funding. Two weeks ago, supervisors unanimously approved Flynn’s “battle plan” to seek the help of top-ranking officials on the matter.

“Our chances to save the Medicare money are better now that we’re working with our political leaders on the federal level,” Flynn said. “It’s better to fight this and get the higher reimbursement rate.”

Emery Lee, billing specialist in the San Francisco financing administration office, said his agency has not yet reviewed the letter. It is too early to tell whether his agency would be swayed by the senators’ action, he said.

The clinic problem centers on the agency’s 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 most of the county’s clinics are outpatient satellites because they are located more than nine miles from the public hospital in Ventura. The difference between the Medicare reimbursement rates is about $2 million each year.

Flynn hopes to persuade the administration to change or drop the rule. If the county loses the money, some of the clinics could be forced to close, officials said.

“We have a better chance of having a positive impact now that top-ranking officials are involved,” Flynn said.