The Audit Committee of the McHenry County Mental Health Board met this morning to hear the audit findings on The Advantage Group, known as “TAG” for short.
The first part of the meeting was a presentation of findings the inside compliance officer found troubling.
A sample of 160 files were taken from a specific time period and ten percent were examined in detail.
There were three complaints:
- that billing was made to both the Mental Health Board and private insurance or Medicaid in cases where double billing was prohibited by the insurance company or Medicaid (“We cannot supplement Medicaid.”)
- that one of the bills showed billing that appeared to be physically impossible for the clinician
- that intake activity was billed, a prohibited practice
Extrapolating from the apparent assumption that all billings from TAG were faulty, staff estimated that the 708 Board had overpaid TAG over $1.1 million over three years, the assumption seemingly being that it had to be paid back.
Under rules of the 708 Board, the time for contesting the audit’s findings is past.
Interim Executive Director Todd Schroll warned that the Office of Inspector General of the Department of Human Resources is also probing The Advantage Group.
Former County Board member Don Larson, now a member of the 708 Board observed, “In the past we’ve had these problems with other providers and worked out a plan to repay or get less funding.
“Can that still be done?” he asked.
Duane Lahti, Manager of Data/Information Systems, reply: “If we do it, it’s a change to the process. That’s why we’ve come to you.”
Attorney Frank Gosser pointed out that there had already been “conversations between staff and TAG.”
He warned about subverting the process and “creating a scenario where other providers” would be treated differently.
“Could we start this process over or could we just talk to them,” asked Audit Committee head Heather Murgatroyd.
“We need to have some discussions about settlement,” Schroll said.
“We would be very surprised that TAG wold survive whatever the Office of Inspector General would [find],” Gosser added.
“We’re at the point where you have to sue them or [otherwise] work it out.”
“I don’t question the validity of the audit,” new member Carrie Smith said.
Commenting on the $1.1 million that the audit says TAG owes, Schroll explained, “There is some concern of the money out there.”
He suggested a settlement agreement that is “contingent upon what we’re expecting the IOL is going to report.”
Larson wanted to know how long TAG might have to pay any money back.
“Probably ten years,” Gosser replied. Immediately thereafter, he suggest it “could be over twenty years.”
“It’s not a question of whether people are getting good service, quality service,” the IT man observed.
Smith then revealed she had agreed to be on the Board to provide “services for all people who need them.”
She worried that TAG would end up “dead, dead, dead. If we take the highest line possible, they’re not there.”
“I don’t believe the answer is necessarily $1 million,” Schroll replied.
Gosser said the current status does not eliminate the possibility of a discussion.
He said her was hearing concern for the people who need services provided by TAG.
When he asked now departed Executive Director Sandy Lewis last year, she told him that there was enough support within the county to meet the needs of all the people.
“I would very much like to go forward,” Smith said.
“I believe they are interested in moving ahead,” Schroll replied.
Gosser stressed that in any agreement TAG would have to “earn the money” by “providing services.
“You can’t just give money away.”
[No mention was made of the $1.4 million loan, never repaid, to Family Services.]
“They need access to substance abuse services,” Schroll said. (Later he noted that there was $425,000 allocated to substance abuse services.)
Smith observed that many community members thought the dispute between TAG and the Mental Health Board was pretty ugly.
“How can we start out fresh,” she asked.
Gosser minimized the intensity of the dispute, recalling the July 25, 2012, meeting at which “TAG was very gracious in admitting, ‘We made some mistakes.'”
In answering the question of how to move forward, Schroll suggested engaging a mediator.
“We are not trying to victimize the provider…
“There’s no question they are successful in many that they serve.”
“Clearly, there were some billing errors,” Murgatroyd said. She wondered if TAG staff needed training assistance.
“We should make the approach to TAG and get this started,” Larson concluded, but added, that he was unwilling to advance more money.
“We’re not talking about quality of service; we’re talking about money,” Gasser said.
“I think what I’m hearing this morning is very positive,” said Cathy Garrey, Compliance and Quality Assurance Manager.
“I feel validated…If there’s a way to make this work…I don’t see any problem moving forward.”
Smith indicated the Board’s goal should be “being good stewards of the taxpayers’ money and serving those in [most] need.”
County Board members Mike Walkup and Donna Kurtz attended the meeting, as did the new 708 Board President Rob Routzahn.
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The Northwest Herald’s story by Kevin Craver can be found here.