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Gill-Montague schools owe Feds $900K

  • Turners Falls High School is at 222 Turnpike Road in Montague. RECORDER STAFF/SHELBY ASHLINE



Recorder Staff
Tuesday, October 10, 2017

TURNERS FALLS — Due to a five-year billing mistake, the Gill-Montague Regional School District owes the federal government more than $900,000 in past Medicaid reimbursements the district should not have collected.

Superintendent Michael Sullivan confirmed to the board the result of the ongoing issue and said it’s a serious issue for the district. He and the district’s budget director talked with staff at the Boston office of the federal Health and Human Services Department in late September, who confirmed to the district that it was financially liable for the past incorrect reimbursements, which total about $936,000.

Sullivan said they spoke with Caitlin Feuer, Cross Agency Medicaid and School-Based Medicaid Program Manager for the Executive Office of Health and Human Services in Boston.

“Ms. Feuer confirmed that the district is legally required to pay back the portion of Medicaid reimbursements we received for which it has now been determined we were ineligible,” Sullivan said in a memo to the School Committee. “According to HHS, the total payback is $936,254, covering over-reimbursements for expenses incurred from FY 2010 through FY 2015. (The estimates shared with you on August 6, 2017 did not include over-reimbursements in FY 2010 of $193,875, which may not be legally required, as federal law limits look backs to six years.)”

Sullivan said the Health and Human Services office has understood the financial situation of the district and has been willing to do a multi-year payback plan.

“Clearly a School District of our size doesn’t have those funds available all at once,” he said.

Sullivan had previously brought the issue to the board in April of this year and did so again at Tuesday night’s meeting. The issue involves the district’s Medicaid billing provider, New England Medical Billing, and what the district thought was billable services to students with medical needs. The district did not know that any reimbursable services must be authorized in writing by a nurse or doctor.

The billing company informed the district in April that there was a discrepancy with the reimbursements, and the district would be receiving less than previous years. After that, the district then learned they had been filing reimbursements incorrectly with the billing company since 2011. The district then hired a lawyer more specialized in this field to help navigate this process.

The School Committee passed two measures related to the issue during Tuesday night’s meeting: one authorizing the payment for the lawyer the district hired to help address the situation and one to continue to use the lawyer in the future. Sullivan said that going forward, the district’s administration is looking into what responsibility New England Medical Billing, which handled the billing for the district, has in the issue.

“There may be some financial burden that is shared with our Medicaid service provider,” he said.

Reach Miranda Davis at 413-772-0261, ext. 280 or mdavis@recorder.com.