County Lobbyists Hit Road to Find Path Out of Fiscal Mess

Hoping to alleviate the county’s financial problems, local officials will spend today and Thursday in Washington, lobbying to undo a ruling that has cost the county $3 million in reduced Medicare health-care reimbursements to date and will continue to cost an estimated $1.6 million a year.

Chief Administrative Officer Harry Hufford said he and other leaders are scheduled to meet with officials from the federal agency that administers the Medicare program, congressional staffers familiar with health-care legislation and lobbyists with the National Assn. of Counties.

They also will meet with staffers for U.S. Sens. Barbara Boxer and Dianne Feinstein, who last fall urged the U.S. Department of Health and Human Services to reconsider a decision to lower the county’s Medicare reimbursement rate at most of its public health clinics.

Officials with the U.S. Health Care Financing Administration ruled in June that clinics nine miles or more from the Ventura County Medical Center in Ventura are too far to be considered hospital-based, a status that brings higher reimbursements.

Federal officials determined 34 of 43 county clinics had improperly been reimbursed at hospital-based rates when they should have received the lower rate set for free-standing clinics.

The county contends the clinics are satellites of the public hospital and benefit the public by being spread across the county, providing better access to preventive medicine that could ultimately save taxpayer dollars.

Recouping some of those lost dollars would help the county balance its $1-billion budget, which is facing a projected $5-million deficit for the current fiscal year. It would also aid in stabilizing the county’s long-term finances, a more pressing challenge the Board of Supervisors will address at a special budget session Tuesday.

County cash flow has suffered in recent months because of at least $11 million in unexpected payouts associated with a 1998 decision to merge the mental health and social service departments. That decision prompted a county psychiatrist to file a federal whistle-blower lawsuit, alleging years of fraudulent Medicare billings in the Behavioral Health Department.

Supervisors agreed to pay $15.3 million to settle that lawsuit and are still dealing with other fines and administrative fallout.

A separate effort, shepherded by Rep. Brad Sherman (D-Sherman Oaks), is underway to persuade the federal government to reduce the $15.3-million settlement by at least half.

Hufford said he will tell federal officials the county honestly believed it was entitled to the higher rate and should not be penalized for good-faith billing practices.

Furthermore, he will argue the county’s clinic-based approach to services is a national model, one the federal government is trying to encourage other counties to adopt. To punish Ventura County sends a mixed signal to other counties, he said.

“The national policy is to encourage the development of providing services in clinics,” Hufford said.

He said the federal government is increasing the reimbursement rates for clinics to encourage health-care providers to move away from hospital-based care. Hufford is hopeful that move is a sign regulators will be open to negotiations.

But Hufford acknowledged that he and the other members of the lobbying entourage--Health Care Agency Director Pierre Durand, Durand deputy Mike Powers, County Counsel Jim McBride and lobbyist Tom Walters--are not counting on returning with a commitment.

“We’d love to get an immediate ‘yes,’ but our experience is it doesn’t work that way,” Hufford said.