- The Washington Times - Thursday, December 21, 2006

The director of the D.C. Department of Mental Health yesterday said the agency is working to correct its failure to obtain federal reimbursements for Medicaid services — a breakdown that has been blamed in part for a projected $300 million shortfall in the District’s budget over the next two years.

“Historically, a lot of money got left on the table,” department director Stephen T. Baron said. “We’re going back as far as we can go to really improve our performance in that area.”

The Department of Mental Health and the Mental Retardation and Developmental Disabilities Administration received the majority of blame after D.C. Chief Financial Officer Natwar M. Gandhi said last month that the District was already $87 million over budget for fiscal 2007.

Mr. Gandhi also predicted that the city could be more than $215 million over budget for fiscal 2008.

The reasons cited for the overruns include that the two agencies often do not submit documents to receive federal reimbursements for Medicaid and Medicare services.

The District can receive a 70 percent match from the federal government for payments made for Medicaid services. Mr. Baron said his agency has submitted claims for the funds but has been largely unsuccessful at revisiting claims that are denied reimbursement.

“It’s not that we’re ignoring it,” he said. “The initial claim goes in, but if it somehow gets rejected by Medicaid, we didn’t have a structure to rework and resubmit the claim.”

Mr. Baron said the agency is working to resubmit some claims filed in the past 27 months. There are roughly $10 million in rejected reimbursements the agency could potentially recoup, some officials say.

The department is planning to contract with accounting firm KPMG to help oversee the revenue collection, and the D.C. Council recently approved $1.5 million that will primarily go toward helping the agency improve its billing and claims processes.

Mr. Baron, the former president of Baltimore Mental Health Systems Inc., was nominated to lead the mental health department by Mayor Anthony A. Williams this year and officially took over in July.

He said he has met with Mayor-elect Adrian M. Fenty but does not know whether he will be retained in Mr. Fenty’s administration.

“I very much would like to stay,” Mr. Baron said. “We’ve begun moving the system forward. There’s tremendous potential here.”

Mr. Baron said the agency has made a number of improvements in the past six months. For example, the department broke ground Tuesday on a new St. Elizabeths Hospital in Southeast.

The $140 million building will house 292 patients — about 130 fewer patients than the current hospital on the same site — and will take 30 months to build, officials said.

The patients also will have their own rooms in the building. Some of the downsized population will be shifted to other hospitals, while others will be shepherded back into society with the oversight of wrap-around community services.

“The hope would be that St. Elizabeths would really reduce its acute care function,” Mr. Baron said. “That would be shifted to the general hospital psych units, and St. Elizabeths would provide the intermediate and long-term care, and forensic care.”

The department also hopes to roll out a program in the next two months that will create community liaisons for mentally ill inmates at the D.C. Jail.

The liaisons will be tied to five community-based service providers. They will aid prisoners while they are incarcerated and when they’re released.

“I feel we have potential,” Mr. Baron said of the program. “Everything takes a little while to work the kinks out, but I think we’re laying the groundwork.”

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