A financially troubled Augusta mental health center could face repaying as much as $770,000 in possibly unauthorized Medicaid billings, officials said Tuesday night.
The Georgia Bureau of Investigation has subpoenaed every Medicaid billing record since January 2000 submitted by the Community Mental Health Center of East Central Georgia, said Nancy Williamson, the chairwoman of the center's board.
The Georgia Department of Human Resources' Office of Investigative Services and Office of Audits are also investigating after center official Sharon Haire wrote a two-page, unsigned letter alleging corruption and cronyism at the center. She was demoted, filed a whistle-blower lawsuit last week and will be fired today, but not because she wrote the letter, according to a statement from the center.
At the heart of the potentially unauthorized payments are what center officials are calling "the switch."
Georgia Medicaid employs an outside firm to evaluate and authorize requests for some mental health services, and there is a "switch," or restriction, within the Augusta center's software that would not submit an electronic billing without it, said center contractor Janet Mann, of Capitol Health Systems. The switch was turned off sometime in late July, and that could be done only by "management," Ms. Mann said.
"(Executive Director) Mike Brockman made that decision," said the board's Finance Committee chairman, Jack Cheatham. Mr. Brockman was put on paid leave last month at the beginning of the investigation.
There could be as much as $770,000 in unauthorized payments, said Stan Markowski, the center's manager for management information systems.
Capitol Health, which in August began a $1.2 million-a-year contract to handle the center's accounting, received a $100,000 bonus for increasing billing and efficiency, Ms. Mann said.
"When I was interviewed by the GBI, they asked me about (the switch)," acting Executive Director Phil Horton said.
That is not the only problem at the center. Billings and expenses are so off that trouble looms ahead, Dr. Cheatham said.
"By April or May, at the rate we're going now, we will be drowning in red ink," he said.
Not if they make some cuts and take a look at a few contracts, Dr. Horton said. For instance, the contract with Capitol Health Systems "is costing us three times what it was before when our own people did it," he said.
It is a five-year contract, Ms. Mann said, but acting Business Manager Mark Hilton said that before Jan. 1, the center was contractually restricted from signing multiyear contracts.
Rather than breaking contracts and risking lawsuits, however, it may be better to try to renegotiate, said board member Gloria Frazier.
"If we don't have money for payroll, how are we going (to pay) legal fees?" she said.
Reach Sylvia Cooper or Tom Corwin at (706) 823-3228.
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