Editorial: Mounting confusion over who’s on the hook for missing budget money

Wednesday, October 25, 2017

Our public school systems spend millions of dollars every year educating our children. So it comes as no surprise that when financial mistakes are made, the numbers add up fast.

Greenfield discovered an unexpected half-million dollar hole in its budget a few years back, as did Mohawk Trail Regional School District. And currently, both Pioneer and Frontier districts are trying to stanch red ink in their lunch programs.

But Gill-Montague School District’s latest fiscal woes take the prize. The federal agency that makes Medicaid payments for needy students in the Gill-Montague district wants to claw back as much as $936,254 it gave the district over six years.

Superintendent Michael Sullivan broke the bad news to the Gill-Montague Regional School Committee recently after meetings with staff at the Boston office of the U.S. Health and Human Services Department, where officials insist the district is liable for past incorrect payments. The period in question covers fiscal years 2010 to 2015.

The problem involves a third party Medicaid billing service provider, New England Medical Billing, and what the district mistakenly thought were 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, according to Sullivan. And it seems the professional billers the district hired didn’t catch the mistake in a timely manner, for reasons that are unclear.

The billing company informed the district in April that there was a discrepancy with the reimbursements, and the district would be receiving less than in previous years. After that, the district learned it had been filing reimbursement requests incorrectly since 2011.

Sullivan said the Health and Human Services office is willing to work out a multi-year payback plan, which is helpful, given that the district doesn’t have an extra $1 million lying around.

But we aren’t so sure the district’s taxpayers should be on the hook for this. It seems that there were two other parties to this mistake: The billing firm and the HHS, both of which are supposed to know more about this bureaucratic process than local educators. You would think that’s why the billing company was hired in the first place.

So we were glad to hear Sullivan say he is looking into what responsibility New England Medical Billing has in this.

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

The district has hired a lawyer specialized in this field to help resolve the issue. We hope the lawyer will be worth the money and can persuade the other two agencies to share the pain this mistake is going to inflict on the district.