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Medicaid review of EP schools continues By DAMIAN MANN EAGLE POINT � Like school systems throughout the country, the Eagle Point School District has found itself mired in red tape for almost two years as three state and federal agencies conduct an ongoing investigation into past Medicaid reimbursements for special education students. The U.S. Attorney�s Office, the Office of Inspector General and the Oregon Department of Justice have been sifting through Medicaid records compiled by the district from 1994 to 2000 to make sure they were completed correctly. "In the health care arena in the last five years, there has been a very concerted effort to try to ensure that every provider of every health service is strictly adhering to every syllable, comma and every regulation of every statute," said the district�s attorney, Joyce Bernheim of the Portland law firm Miller Nash LLP. She said school districts and other institutions throughout Oregon and the United States are being heavily scrutinized by the government. "This is part of a coordinated national effort," she said. Schools often administer Medicaid programs to help students with disabilities receive funding for health costs associated with physical therapy and other health-related programs. Bernheim said the issue is complex, especially because it involves two complicated systems: education and the federal government. "It is a very daunting situation." Neither Bernheim nor district officials would discuss specifics of the investigation, though Bernheim said, "It is pretty document-intensive." Superintendent Bill Jones said, "There is an ongoing investigation. There is not an issue of fraud." Bernheim agreed. "The school district does not believe there was any fraud," she said. She said an exact dollar amount for the Medicaid reimbursements to the district has not been compiled, nor has the number of reimbursements been counted. State and federal officials would neither confirm nor deny that there is even an investigation underway. Ellyn Sternfield, director of the Medicaid Fraud Unit for the Oregon Department of Justice, would only say that her office routinely investigates cases where Medicaid fraud is suspected. Typically, these investigations take many years to complete. For instance, a case against Nichols Laboratory, which serves Oregon, Washington and Alaska, was recently settled for $13 million after her office investigated the company during a six-year period, she said. As to discussing any ongoing cases, Sternfield said, "We need to protect the confidentiality of the Medicaid provider." The investigation into school districts and other Medicaid providers was prompted by reports issued by the U.S. General Accounting Office, which raised concerns about improper payments and the need for improving oversight. Medicaid provided about $2.3 billion for school activities, some of that going to pay for administrative activities, according to a GAO report. Part of a complex funding issue, the GAO also reported that some schools might not have received full reimbursement. In some cases, only $7.50 for every $100 claimed was returned to the schools. In some states as much as 85 percent of the federal reimbursement for Medicaid is kept by the state. In a letter from the GAO, it stated, "In particular, we found that weak and inconstant controls over the review and approval of claims for school-based administrative activities created an environment in which inappropriate claims could generate excessive Medicaid reimbursements." In another of many GAO reports on the subject, the government agency said the question of reimbursements for Medicaid is a confusing issue for schools. Reach reporter Damian Mann at 776-4476, or e-mail [email protected] Mail Tribune Home | Ottaway Newspapers, Inc. | Dow Jones & Co., Inc. | Privacy | Contact Us Copyright � 2001 Mail Tribune, Inc.