VENTURA COUNTY: Administrator Demands Tougher Mental Health Oversight
Mid-way through settlement talks with the federal government relating to years of improper Medicare billing, Ventura County Chief Administrative Officer Lin Koester dispatched a memo Tuesday to Health Care Agency Director Pierre Durand, ordering "strict enforcement of all Medicare rules regarding mental health care billings," the Ventura County Star reports. Specifically, Koester ordered the agency to document medical necessity for all Behavioral Health Department submissions to Medicare; create an "internal audit system"; hire consultants if necessary to ensure compliance; and provide Koester with regular progress updates. The U.S. Attorney's Office investigation began last January and uncovered incidences of billing for psychiatric treatments without documenting medical need, using a doctor's name for services that were not provided or authorized, billing for counseling provided by a social worker or nurse under a doctor's name and entering incorrect codes for treatments. The talks, which will continue into next week, will determine the county's amount of repayment and possible penalty, both of which depend on whether the violations were intentional, how much money they represent and how long they lasted (Koehler, 6/30).
Vying for a Piece of the Pie
In related news, Ventura County Behavioral Health Director David Gudeman made a final plea at the Board of Supervisors' final budget meeting this week for $1.5 million to "provide more treatment beds and apartments so" the 4,000 "seriously mentally ill" county residents "can live more independently." The Ventura County Star reports that the supervisors will assess Gudeman's plan today as they draw up the 1999-2000 budget. Gudeman, who outlined exactly how the funds would be used, seeks 69 beds in apartments, homes and residential programs throughout the county, which would feature varying levels of supervision, ranging from 24-hour aid to semi-independent living. Mental health advocate Pearl Lieber said, "I believe there's enough money (in the budget) for many people to indulge in the big pie. When it comes to mental health, it's time. We need to take care of it -- now more than ever before" (Pyle, 6/29).