By BOB MONTGOMERY
While one local health care provider has satisfied its nearly $500,000 Medicaid debt with the state, four others with area offices still owe nearly $1.4 million, according to the N.C. Department of Health and Human Services.
The four private providers with offices in Elizabeth City are: Life Inc., 405 W. Main Street; Pride in North Carolina Inc., 905 Halstead Boulevard; Innovative Programming Associates (IPA), 1023 U.S. Highway 17 South; and Health Services Personnel, 905 Halstead Boulevard.
Those four firms owed a total of $1.8 million and have repaid through withholding of payments $438,082 to date — or about 24 percent of the debt, according to data from the state DHHS.
DHHS spokesman Brad Deen estimates that 500 community service providers statewide owe a total of nearly $60 million in Medicaid repayments that were used for non-qualified services. The federal government announced in mid-April that it was withholding at least $138 million from North Carolina in Medicaid funding until it submits an acceptable plan to deal with the misspent funds.
All of the firms, which are paid to provide counseling and other services to mental health patients, were ordered to repay the monies DHHS said had been misspent. To speed up the recoupment, DHHS began withholding 10 percent of the firms' Medicaid reimbursements.
One local firm that owed $483,041, American Health and Human Services, has satisfied all its debt, Deen said.
Meanwhile, the other four with offices in Elizabeth City have satisfied roughly one-quarter of their debt through withholdings. According to DHHS records:
— Life Inc., which owed $1.1 million, has repaid $315,643.
— Pride in North Carolina Inc., which owed $459,051.12, has repaid $112,989.71.
— Health Services Personnel, which owed $137,784.84, has repaid $60,104.57.
— Innovative Programming Associates (IPA), which owed $129,159, has repaid $49,345.15.
When contacted, the local providers referred questions to their corporate offices.
Life Inc. executive vice president Sammy King referred questions to Sharon Raynor, president, who could not be reached.
Health Services Personnel executive Jim Southern declined to comment and referred questions to Todd Key, state director, who could not be reached.
IPA 's Tonya Boyce in Elizabeth City could not be reached for comment.
Meanwhile, Pride in North Carolina Inc.'s president, Deanna Janus, said she has appealed the state's action, although the state is still continuing to withhold 10 percent.
She said some of the funds the state wants to collect are for services that providers were told to continue providing for existing patients — then later told not to.
"The division was very clear not to reduce services," Janus said. "We were told to continue (treating them) as community service providers."
Janus said her business has tried hard to follow all the rules, many of which were unclear and provided "little guidance" from the outset.
"They set up a system destined to be abused by providers without integrity," she said.
Wednesday, April 30, 2008
By BOB MONTGOMERY
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