"I'd say the honeymoon is over."
-- Bob Duncan, Modoc Medical Center CEO, in his new position just over 20 days, faced with having to pay Medicare back $767,000.
Thursday, December 17, 2009
Quotes to Remember
"I'd say the honeymoon is over."
-- Bob Duncan, Modoc Medical Center CEO, in his new position just over 20 days, faced with having to pay Medicare back $767,000.
MMC Averts Disaster
It appears Modoc Medical Center (MMC) has averted the possibility of going into debt once again by working out a five-year payment plan to reimburse Medicare $767,000 it over paid the hospital.
New MMC CEO Bob Duncan told the Modoc Independent News today (Dec. 17) that Medicare has agreed to a five year repayment plan for the $767,000, plus interest, which calculates out to approximately $13,000 per month not including interest payments.
The interest rate will be about 10 percent, according to Duncan. Because interest paid to the government is not tax deductible, Duncan indicated that he will seek a private bank loan with tax deductible interest to pay off Medicare ahead of schedule.
The over payment came to light this week when outside cost auditor Michael Bell informed MMC officials that he discovered Medicare had overpaid the hospital $767,000. Typically, over payments by Medicare are due and payable in one lump sum, according to one source.
Asked how the Medicare over payment could have happened, Duncan said that when MMC gained Critical Care Access status in October, 2008, Medicare calculated reimbursement rates based on historical cost data. In other words, according to Duncan, they applied MMC past rates to the current situation, which meant they calculated the amounts they reimbursed on a rate schedule that was different than the current pricing.
Meanwhile, MMC patient numbers went up significantly, and Medicare reimbursed for this increase at the wrong rate.
Nevertheless, when hospital administrators received a check that was $767,000 more than it should have been, red flags should have gone up, particularly in light of the fact that MMC rates charged to patients were raised in the past few months, according to a source that asked for anonymity because they were not authorized to discuss the issue of over payment.
Duncan also said that typically district and private hospitals put money aside in reserve, knowing this Medicare roller coaster will invariably impact them. He said that MMC received a huge Medicare reimbursement check in May, about the same time the hospital was starting to show a profit, that was retroactive to October, ‘08.
At that time CFO Monica Derner started putting money aside, anticipating a Medicare charge back, according to Duncan.
MMC has $400,000 in reserves, and Modoc County Treasurer Cheryl Knoch has confirmed that the funds are intact.
-- Barbara March
New MMC CEO Bob Duncan told the Modoc Independent News today (Dec. 17) that Medicare has agreed to a five year repayment plan for the $767,000, plus interest, which calculates out to approximately $13,000 per month not including interest payments.
The interest rate will be about 10 percent, according to Duncan. Because interest paid to the government is not tax deductible, Duncan indicated that he will seek a private bank loan with tax deductible interest to pay off Medicare ahead of schedule.
The over payment came to light this week when outside cost auditor Michael Bell informed MMC officials that he discovered Medicare had overpaid the hospital $767,000. Typically, over payments by Medicare are due and payable in one lump sum, according to one source.
Asked how the Medicare over payment could have happened, Duncan said that when MMC gained Critical Care Access status in October, 2008, Medicare calculated reimbursement rates based on historical cost data. In other words, according to Duncan, they applied MMC past rates to the current situation, which meant they calculated the amounts they reimbursed on a rate schedule that was different than the current pricing.
Meanwhile, MMC patient numbers went up significantly, and Medicare reimbursed for this increase at the wrong rate.
Nevertheless, when hospital administrators received a check that was $767,000 more than it should have been, red flags should have gone up, particularly in light of the fact that MMC rates charged to patients were raised in the past few months, according to a source that asked for anonymity because they were not authorized to discuss the issue of over payment.
Duncan also said that typically district and private hospitals put money aside in reserve, knowing this Medicare roller coaster will invariably impact them. He said that MMC received a huge Medicare reimbursement check in May, about the same time the hospital was starting to show a profit, that was retroactive to October, ‘08.
At that time CFO Monica Derner started putting money aside, anticipating a Medicare charge back, according to Duncan.
MMC has $400,000 in reserves, and Modoc County Treasurer Cheryl Knoch has confirmed that the funds are intact.
-- Barbara March
Wednesday, December 16, 2009
MMC: Must Repay Medicare - $767,000
Modoc Medical Center spokespersons CEO Bob Duncan and CFO Monica Derner confirmed today that Medicare overpayments to MMC in the amount of $767,000 will have to be repaid.
Duncan said, “This is typical in our business, especially for a new Critical Care Access hospital,” and then shifted his approach to the unwelcome news, “This is a double sting. The mistake has been compounded by the fact that MMC has reduced its expenses and increased volume.”
Duncan said the funds will be repaid by the hospital either in a monthly payment arrangement with Medicare or through a loan from a private bank.
He offered this explanation: “When MMC gained Critical Care Access last October the reimbursement rate was calculated based on historic information. Things have changed since then, our costs are down, our volume is up.”
Derner added, “We have $400,000 in reserves and hopefully we won’t have to touch that to pay back Medicare.” She went on to say that the county will not be forced to fund the hospital again and that trends for MMC to continue to operate in the black look good.
NEWS FLASH
The Modoc Independent Daily News blog has received unconfirmed reports from two sources that Modoc Medical Center will have to repay $700,000 in Medicare overpayments. Efforts to reach hospital officials for confirmation have been unsuccessful. We will report on this story as it develops.
Modoc County Fiscal Restoration Update
Editor's Note: The following ICS Report is published verbatim.
The Incident Management Team is moving forward doing an in-depth analysis of funding sources in the County. Good decision making in these areas will generate not only short term positive solutions but long term solutions to this fiscal matter.
Operational Period Accomplishments 12/07/09-12/14/09
The Modoc County Liaison team consisting of Diane Fogle, Cal Works, Dan Macsay, Board of Supervisors, and Kim Hunter, Planning Department attended the City Council meeting on 12/08/09 that led to exploration topics including the trapper and City and County sharing of staff. Sharing of staff will allow City Planner, Chester Robertson to work on the County Fiscal Restoration Group. The Planning Department, Kim Hunter is helping alleviate some of Chester’s regular duties in the area of Planning. The City Council expressed there may be other ways in which they can assist the County. The County and City Council both felt it was a positive step to improving communication. Continued communication will take place between the Liaison Team and attendance at future Council meetings.
The County audit is on schedule and should be completed as planned.
Due to this fiscal crisis the Road Department has limited snow plowing hours. Monday through Friday, 8 hour days. There will be no plowing on weekends and/or evenings due to overtime costs and downsized workforce.
The County should know by the end of December if the short term
financing is approved.
Work will continue by all of the groups on the Incident Management Team. Another update will be available on January 4, 2010. Happy Holidays to everyone.
The Incident Management Team is moving forward doing an in-depth analysis of funding sources in the County. Good decision making in these areas will generate not only short term positive solutions but long term solutions to this fiscal matter.
Operational Period Accomplishments 12/07/09-12/14/09
The Modoc County Liaison team consisting of Diane Fogle, Cal Works, Dan Macsay, Board of Supervisors, and Kim Hunter, Planning Department attended the City Council meeting on 12/08/09 that led to exploration topics including the trapper and City and County sharing of staff. Sharing of staff will allow City Planner, Chester Robertson to work on the County Fiscal Restoration Group. The Planning Department, Kim Hunter is helping alleviate some of Chester’s regular duties in the area of Planning. The City Council expressed there may be other ways in which they can assist the County. The County and City Council both felt it was a positive step to improving communication. Continued communication will take place between the Liaison Team and attendance at future Council meetings.
The County audit is on schedule and should be completed as planned.
Due to this fiscal crisis the Road Department has limited snow plowing hours. Monday through Friday, 8 hour days. There will be no plowing on weekends and/or evenings due to overtime costs and downsized workforce.
The County should know by the end of December if the short term
financing is approved.
Work will continue by all of the groups on the Incident Management Team. Another update will be available on January 4, 2010. Happy Holidays to everyone.
Tuesday, December 15, 2009
Editorial
Message to GJ: Get Tough
Today is a political landmark for Modoc County. The grand jury is meeting with our board of supervisors.
Of significance is the fact that three members of this board are responsible, according to the State Controller’s Office, of misappropriating an estimated $20 million from the county’s treasury.
We hope they don’t just talk about the weather.
What’s at stake? Besides our financial future, our reputation to the outside world is at stake, a reputation that can be improved but almost certainly can’t get any worse. What the board did in moving money from the treasury without authority to do so was illegal and as a result we are facing insolvency. You can call it bankruptcy.
For years the board of supervisors has snubbed every attempt by the grand jury to right their wrongs or indiscretions and those of their immediate administrators. All you have to do is read the latest grand jury report to learn that the board of supervisors has been in non-compliance in its response to the grand jury every year since 2003. Will today be any different?
The fact that the grand jury is now interviewing our supervisors is a positive move, but we may not know if it was a productive investigation until next summer when the grand jury’s report is released.
In the meantime, it’s our opinion that following today’s closed session with our supervisors the grand jury should determine if District Attorney Gary Woolverton should start investigative proceedings against at lease three members of the current board.
-- Ray A. March
Monday, December 14, 2009
Plumas Bank Recognizes Kindness
Kindness is more important than ever in today's world. Sometimes it can come to you without you even knowing it, in various styles, shapes and forms. Take the time to notice.
Tell Plumas Bank your story about how kindness has touched your life or the lives of others in our community and the difference that one special person has made.
Nominate a candidate for the Plumas Bank Kindness Award, a person who performs an Act of Kindness in our community from December 1, 2009 through November 30, 2010. Plumas Bank will celebrate one person each month throughout 2010; and, on their 30th Anniversary in December, 2010 one of the twelve nominees names will be drawn to win a $300 prize.
For more information or to obtain a nomination form, visit our website at www.plumasbank.com or your local branch.
Editor's Note
Since posting the following article “Grand Jury to Meet with BOS“ we have learned that California Government Code Section 54953.1 actually allows for a board of supervisors to meet as a whole with a grand jury, and we quote:
“The provisions of this chapter shall not be construed to prohibit the members of the legislative body of a local agency from giving testimony in private before a grand jury, either as individuals or as a body.”
We remain convinced, however, that it would be a tactical mistake for the Modoc County Grand Jury to conduct such a meeting when it has a more productive opportunity to question supervisors individually as to how an estimated $20 million was misappropriated from the county’s treasury by them and other county officials.
Sunday, December 13, 2009
Grand Jury to Meet with BOS
A first sign that the Modoc County Grand Jury may be investigating the Board of Supervisors and its misappropriation of an estimated $20 million from the county treasury appeared Dec. 8 during the board’s regular session.
The grand jury’s interest in the board of supervisors came in a routine agenda item, listed under “Administrative Report,” near the end of the board’s meeting.
The news was received in an off-handed manner by Chair Patricia Cantrall, while the other supervisors remained silent.
The entire board is to appear in closed session tomorrow (Dec. 15), according to Clerk of the Board Stephanie Northrup. The complete roster of the grand jury is expected to question the supervisors rather than routinely leaving the inquiry to the grand jury's local government committee.
If such a meeting is held in which a majority of the board is present there is the possibility that it will be in violation of California Brown Act, which governs the rights of the public to attend and participate in meetings conducted by local legislative bodies.
A meeting includes any congregation of a majority of the members of the legislative body on any matter related to their local jurisdiction and requires certain advance public notice depending on the urgency of the meeting.
Criminal penalties can be applied to members of local legislative bodies such as boards of supervisors, for attending meetings in violation of the Brown Act.
-- Ray A. March
The grand jury’s interest in the board of supervisors came in a routine agenda item, listed under “Administrative Report,” near the end of the board’s meeting.
The news was received in an off-handed manner by Chair Patricia Cantrall, while the other supervisors remained silent.
The entire board is to appear in closed session tomorrow (Dec. 15), according to Clerk of the Board Stephanie Northrup. The complete roster of the grand jury is expected to question the supervisors rather than routinely leaving the inquiry to the grand jury's local government committee.
If such a meeting is held in which a majority of the board is present there is the possibility that it will be in violation of California Brown Act, which governs the rights of the public to attend and participate in meetings conducted by local legislative bodies.
A meeting includes any congregation of a majority of the members of the legislative body on any matter related to their local jurisdiction and requires certain advance public notice depending on the urgency of the meeting.
Criminal penalties can be applied to members of local legislative bodies such as boards of supervisors, for attending meetings in violation of the Brown Act.
-- Ray A. March
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