Add Billing Probe to O.C. Disarray

The investigation by the U.S. Department of Justice into possible fraudulent Medicare billings in the county’s mental health programs comes at a time when the Hall of Administration is in disarray over other matters. The challenge will be to get to the bottom of the inquiry and ensure that the problem, which apparently was brought to the county’s attention earlier, gets corrected this time.

The atmosphere at the Hall of Administration in recent weeks has been tense and fractious, hardly the environment for a speedy course correction once a problem is uncovered in a corner of the county’s operations, the mental health services area. That this problem lingered unaddressed suggests how deeply the county’s day-to-day functioning has been sidetracked by other disputes over the airport, and the relationship between county supervisors and the county executive officer.

This environment of mistrust apparently even cast doubt on the method by which county supervisors were apprised of the billing errors. Michael Schumacher, director of the Health Care Agency, talked individually with supervisors about the investigation, and there were some concerns raised about whether county staff had underplayed the seriousness of the probe.

In any case, supervisors now should receive their own briefing as a group on the matter. There are some questions that need answering, among them: Was the so-called coding error willfully done? How early was the problem brought to the attention of the county, and why wasn’t anything done sooner? Who got money and how much?

The Orange County case has been described as being smaller than a Medicare billing investigation in Ventura County last year, which resulted in that county agreeing to repay $15.3 million in Medicare reimbursements made to its health department. In Orange County, billings by the county to Medicare for mental health services are much lower, and the county, unlike Ventura, does not operate its own hospital.

None of that changes the fact that this issue was allowed to go unaddressed. It’s the latest in a series of missteps involving the Health Care Agency, which now shows regular evidence of the consequences of managerial turnover and instability.

The fact that the problem was not corrected even after a software vendor had identified it is an indication of the need to get a better handle on things. While county governmental operations touch on many areas of regional life, health care is one in which direct oversight and management are crucial.

At a time when many are questioning the competence, credibility and even the purpose of county government, managers and supervisors need to do much better.