August 5, 2013

RSU 38 hires lawyer in wake of $847K Medicare overbilling claim

Manchester, Mount Vernon, Readfield and Wayne schools allegedly made mistakes in charging federal government for student services

By Susan McMillan smcmillan@centralmaine.com
Staff Writer

READFIELD — If Regional School Unit 38 has to repay Medicaid for supposed overbilling, it could be hard for the district and its taxpayers to bear.

However, Superintendent Donna Wolfrom said she expects a long process to play out before it's finally determined whether RSU 38 owes up to $847,000 that it received in reimbursements for medical services to students with disabilities.

RSU 38 is one of more than two dozen school districts that the Department of Health and Human Services says overbilled for services such as speech therapy, social workers and nursing care. The $847,000 that the district allegedly owes is the largest amount thus far reported for any of the districts.

"To our small district, that is a huge amount of money, which is why we immediately sought counsel," Wolfrom said.

RSU 38 has joined several of the districts in hiring attorney Robert Nadeau to contest the findings of a state audit done in 2011-2012.

Wolfrom said RSU 38 received unclear instructions from DHHS about how to bill for the services that they are legally obligated to provide students, and they did their best to follow correct procedures.

"We really believe that we were doing what we needed to do," she said.

Wolfrom said she did not know when the supposedly improper billings took place or how much $847,000 is relative to total billings in recent years.

Wolfrom and Special Education Director Ryan Meserve have both been in their jobs about a year. Meserve and Finance Manager Brigette Williams were unavailable for comment.

Nadeau did not return a call on Monday.

At a meeting in May, Meserve told the school board that RSU 38 was found to be noncompliant because there were no individual treatment plans for the cases reviewed in the audit, according to meeting minutes.

He said DHHS and Maine State Billing told school districts that individual education plans could be used instead of the treatment plans, then later said that using that process meant all subsequent billings were noncompliant.

RSU 38 officials hope to eliminate or reduce the amount of money they're required to repay. The total $847,000 is equivalent to about 5 percent of the district's $15.7 million budget this year.

Manchester Town Manager Patrick Gilbert said school officials have not talked with him, nor with the other town managers as far as he knows, about the Medicaid issue. It's too early to say what impact it could have on taxpayers, he said.

RSU 38 consists of Manchester, Mount Vernon, Readfield and Wayne.

Susan McMillan — 621-5645
smcmillan@mainetoday.com

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