VENTURA COUNTY I: HCFA Official Gives Hope to Lobbying Group

      Ventura County health officials got a ray of hope from Thomas Gustafson, director of HCFA's Purchasing Policy Group, when he promised to "take a fresh look" at the county's hospital clinic system, the Ventura County Star reports. In question is a new federal law designed to crack down on the improper classification of clinics as outpatient units when billing for Medicare. Last summer, HCFA's regional office in San Francisco declassified Ventura County Medical Center's 43 health and mental facilities, preventing them from billing under outpatient status and receiving a higher reimbursement. Federal officials said the clinics were "too far away to be considered under the control of the hospital" and "questioned the longstanding practice of contracting with private physicians who are not on the county's staff." The change has resulted in a loss of roughly $3 million, prompting the county to engage in further discussions with HCFA. At the request of state Rep. Elton Gallegly (R-Simi Valley), county personnel met with Gustafson, who said he is "intrigued" by the health system, which "appears to meet 'the spirit of the law' governing hospital clinics." He said the California officials "presented a very good outline of how the health care system in Ventura County operates, how it may not cross the T's and dot the I's of HCFA regulations, but it does meet the intention of the law." A Gallegly spokesperson said the county "just wanted another set of HCFA eyes on the situation." Ventura County Supervisor Kathy Long said she was "encouraged" by the meeting's outcome. Although he did not make any promises, Gustafson said "he would take the matter to his superiors for further review" (Koehler, 2/17).