Response to Medicaid overbilling story

Two Letters to the Editor of the News & Observer on Medicaid overbilling:

http://www.newsobserver.com/opinion/letters/story/781139.html

Involve providers

Regarding your Nov. 16 story "Overbilling found in mental health
program":


Community support services include everything from emergency services to skills-based services to individual therapy. When the Community Mental Health Centers morphed into Local Management Entities, they stopped working directly with clients. They became administrators -- not clinicians. To say that providers have overcharged the government about $45 million for a basic, widely used service, which a state official said, is to completely ignore what took place when the community mental health centers essentially shut down.

More troubling than this, providers have no way to impact N.C. mental health reform. There is no complaint procedure and no way to address issues other than to badger LME administrations, which simply ignore providers because they can.

The Joint Legislative Committee co-chairs might want to consider asking the providers what they believe the problems are. There is no formal way to do this at this time. It needs to be put into the law associated with mental health reform.

Marsha Hammond, Ph.D.
Clinical licensed psychologist
Asheville
http://www.newsobserver.com/opinion/letters/story/781136.html


Mental health results

Regarding your Nov. 16 story "Overbilling found in mental health
program":

You reported that one-third of recipients of community support services were not eligible for the services. As a result, the mental health division has blocked the licensing of new (perhaps more ethical) providers and is withholding 10 percent of payments to providers until all overpayments are recovered.

This story seems to suggest that the providers are the barbarians while North Carolina's mental health bureaucracy stands at the gates to defend the taxpayer. That same human services and mental health organization championed the outsourcing of mental health services billing. That same organization championed the outsourcing of oversight from the case managers who were also outsourced.

The result of these failures is that those needing services can't secure the protection they need. The result is that North Carolina's ability to bill Medicaid and Medicare is limited. The result is that better mental health providers cannot or will not replace the incompetent and unethical providers who overbill. The result is that our court system is choked with cases that could be avoided with treatment and care-giving.

Dempsey Benton is eminently qualified as the new leader for the Department of Health and Human Services. Now all we need to do is replace most of the bureaucrats who report to him.

Don Ward
Raleigh