Region 8 has some serious issues


It’s disappointing, not to mention fraudulent, when a government agency agrees to pay nearly $7 million to settle allegations that it billed Medicaid for preschooler treatment services that didn’t exist.

The settlement, prompted by a former employee’s whistleblower lawsuit, occurred last week. The case involved one of the state’s mental health boards, Region 8 Mental Health Services, which is based in Brandon.

The former employee’s lawsuit said when she worked in the Region 8 Simpson County branch, her instructions were to bill Medicaid as if she was spending time with preschoolers, even when she was not.

Her lawyer, Brad Pigott, said the agency regularly billed Medicaid for services even when employees were doing nothing but watch TV and shop.

They were supposed to be helping preschoolers who had emotional disturbances.

The case is worth discussing for several reasons. One of them is that it shows there is plenty of incentive to be a federal whistleblower. The former employee will receive about $1.25 million of the $7 million from Region 8. It’s good to see honesty get rewarded once in a while.

Another reason is to poke a small hole in the presumed argument that a lack of funds forced difficult budget cuts, which in turn left the Simpson County operation understaffed.

In its story about the settlement, The Associated Press spoke to a Region 8 attorney. After noting that the agency admitted no wrongdoing in the settlement (is denying a problem the best way to get back in Medicaid’s good graces?), the attorney said the payment would not force Region 8 to cut services, and that it would not need to borrow money to pay.

The AP got hold of Region 8’s financial statement from September 2016.

It showed the agency had $20 million in revenue during the 12 months prior to that date, and more importantly it also showed $15 million in cash reserves.

The $20 million figure is not a surprise. Mental health treatment is expensive, and the agency probably used to receive a lot more state and federal money that it does now.

But that $15 million reserve is galling. That is 75 percent of the annual budget — a gigantic amount. How does a mental health agency save up that much money? Hopefully it has been dipping into it over recent years as the state reduced its funding.

 From the point of view of taxpayers, when there is that large of a cash cushion, it is ridiculous to willfully decide not to provide required services, or to allow managers in Simpson County to get away with not providing them, while still seeking Medicaid reimbursement for the work.

Unless forbidden by state or federal regulations, a portion of the reserve money should be used to make up for lost funding.

The truth of the matter is that the state has been too harsh with its mental health cuts. The troubled among us now have fewer places to turn for help, or at the very least they have to wait longer to get treatment. But when you read about a regional agency’s $15 million in reserves, you wonder if the state simply isn’t trying to force them to spend some of that money.