April Edition 2010 - New York Nonprofit Press

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4 New York Nonprofit Press www.nynp.biz April 2010 EDITORIAL Elizabeth Seton Pediatric Center About Elizabeth Seton Pediatric Center’s Home Care Program The Elizabeth Seton Pediatric Center was established in 1988 by the Sisters of Charity. We provide comprehensive rehabilitative care for children with a wide range of medical conditions and disabilities. All of our programs are centered on our children and their families, respecting individual cultural beliefs and practices. The Center has developed an expertise in pediatric care and has established the Home Care Program to bring that expertise from our home to yours. Who Is Eligible For Long Term Home Health Care Children who have extended care needs that require hospitalization or placement in a long term care facility and want to live at home are eligible. Those children may include: • Children with special needs such as • Respiratory Therapy • Tube feedings • Special skin care • Medication injections • Mental Disability Children with multiple care needs and a complex plan of care Children whose health status is apt to deteriorate rapidly Children whose health or functional status can be expected to stabilize or improve with the provision of home care services Children with a poor prognosis for recovery Service Areas Ages Served * Manhattan Birth to 21 years * Queens Payment Sources * Brooklyn Medicaid Medicare * Bronx Private Insurance Private Pay Please call or fax the Home Care Program to make a referral or discuss questions or concerns. Tel: 212.239.6586 Fax: 212.239.6719 Reality Check: Show Us the Revenue Faced with a $9-10 billion budget gap, it is time for New York State to get real about raising additional revenues. While it seems clear that there will have to be cuts to state spending, it is ludicrous for the legislature to think they can balance the budget using only one side of the income statement. Governor Paterson deserves credit for his proposal to create a “soda tax” that would raise $1 billion annually going forward while also offering significant public health benefits. The same goes for increased cigarette taxes. The Senate’s rejection of these revenues while simultaneously restoring critical budget cuts seems less than helpful. As the final section of our cover article “Budget Bombshell” outlines, there are additional tax and revenue proposals which should be explored. Fiscal Policy Institute’s suggested temporary 1% personal income tax surcharge on households earning over $1 million makes sense. So does its “Wall Street Helps Main Street” package of proposals which would seek additional revenues at a time when Security Industry Association member firms are making record profits. Letter to the Editor Dear Editor, I am a faithful reader of the NYNP and our organization benefits from the information you provide. I recently read your article on the new SCORE system for NYC foster care agencies. However, I was disappointed that the perspectives of any of the actual people using the system weren’t included. It would be great to hear whether parents, foster parents or youth thought ACS had accurately captured agency performance. Sincerely, Sarah Gerstenzang, Executive Director NYS Citizens’ Coalition for Children Thank you for your support New York Nonprofit Press Wishes to Thank Our Newest 2010 Organizational Sponsors Founding Sponsors CAMBA Good Shepherd Services Services for the Underserved Supporting Sponsors Catholic Charities of the Archdiocese of New York Lower Eastside Service Center, Inc. Mercy Home for Children The Center for Family Support Community Sponsors Astor Services for Children and Families Central Nassau Guidance & Counseling Federation of Protestant Welfare Agencies Forestdale Human Services Council of New York City JobPath Long Island Cares, Inc. Neighborhood Family Services Coalition New York Asian Women’s Center Northern Manhattan Improvement Corp. Queens Community House, Inc. Visions/Services for the Blind & Visually Impaired SPONSORS
April 2010 New York Nonprofit Press www.nynp.biz 5 OMIG “Extortion” is Subject of Senate Hearing “Extortion” is how NYS Senator Craig Johnson (D-Nassau) described the audit and collection practices of the Office of the Medicaid Inspector General (OMIG) in response to horror stories from healthcare providers. The comments came at a March 17th hearing by the Senate’s Committee on Investigations and Government Operations, which Johnson chairs. During the course of the day-long hearing, the Committee heard from John J. Foley, Deputy Medicaid Inspector General for Audit, who faced tough questions regarding various aspects of the OMIG’s operations, including its aggressive audit protocols, burdensome demands for documentation, the attitudes and qualifications of its staff, and its approach to collecting audit recoupments, which Johnson described as “shaking everybody down.” Foley was followed by two healthcare provider executives who described their own experiences in dealing with OMIG auditors. John Haley described how New York Diagnostic Center, Inc. had been forced to close after OMIG sought recoupment of more than $3 million in payments for same day clinic visits which allegedly should have been provided by an inpatient rehabilitation service, despite what Haley described as prior written approval for the program of services from the Office of Alcoholism and Substance Abuse Treatment Services (OASAS). Haley indicated that the final decision to close came as OMIG moved to “100% withhold” of current Medicaid payments as NYDC continued to fight the audit finding. Bruce Peckman, Chief Operating Officer of Highfield Gardens Care Center of Great Neck, related three separate audit experiences with OMIG. One involved a base year rate NYCON Extends Deadline for SCF Grant Applications The New York Council of Nonprofits, Inc. (NYCON) is extending the application deadline for its Strengthening Communities Fund (SCF) grants to April 14th. NYCON has received a nationally competitive $1,000,000, two-year SCF stimulus grant and will award $600,000 of the grant to community and faith-based nonprofits serving low-income individuals in Manhattan, Brooklyn and the Bronx who are providing services that are vital to the economic recovery efforts. The SCF Program is comprised of two components. NYCON will provide access to and scholarships for free training, access to an online learning community, and consulting support to 80 community and faith-based organizations. NYCON is collaborating with three Nonprofit Training Partners including the Women’s Center for Education and Career Advancement, the Support Center for Nonprofit Management and the Nonprofit Coordinating Committee of New York. The SCF program will offer an extraordinarily POINT NEWS OF VIEW audit going all the way back to 1990 when the facility was under prior ownership which would have ultimately translated into a recoupment claim of more than $30 million. According to Peckman, the facility was ultimately forced to settle for $853,000, despite strongly disagreeing with the finding, after the OMIG had already withheld $800,000 in current Medicaid payments and the threat of significantly higher recoupment had negatively impacted the agency’s ability to obtain credit. Peckman went on to describe two other subsequent interactions in which OMIG staff cited documentation requirements not included in regulation and used the threat of lengthy and expensive legal action as a reason to settle an audit claim. “Providers are living in fear today,” said Johnson, who noted that many other providers had been reluctant to testify publicly about their experiences with OMIG. He cited the experience of Metropolitan Jewish Geriatric Center, which had won a decision overturning the OMIG’s audit finding after appealing to an Administrative Law Judge. Soon after, said Johnson, the agency had received a new audit notification letter. And, on February 17th, only two days after Johnson had questioned OMIG James Sheehan publicly as to why MJGC had not been repaid the monies withheld by OMIG, the agency reportedly received another letter notifying them that the audit parameters were being expanded. comprehensive range of free training opportunities to meet the needs, interests, and goals of eligible secular and faith-based organizations who participate in this program. Under the second component, these 80 program participants will be able to compete to receive a grant ranging from $10,000 to $25,000 and receive 50 hours of free technical assistance. Both the funding awards and technical assistance are designed to build organizational capacity. Approximately 30 community and faith-based organizations will be awarded financial and technical assistance and these organizations will be known as “Project Partners.” Applications will be accepted during two competitive funding rounds that will take place in the Spring and Fall of 2010. The Spring 2010 SCF applications are due April 14, 2010. Questions about the SCF program and application should be director to Program Manager, Jennifer Lockwood at 1-800-515-5012 ext. 152 or jlockwood@ nycon.org. More OMIG! Senate Republicans Urge Higher Medicaid Fraud Recovery Targets The New York State Senate Republican Task Force on Medicaid Fraud conducted a public forum in Albany last month to urge stronger efforts to combat waste and abuse in the program. The Task Force is calling for even higher targets for Medicaid fraud and abuse recoveries by the Office of the Medicaid Inspector General (OMIG). In February, Governor Paterson’s Executive Budget proposed to increase the OMIG’s recovery target for FY2010-2011 by $300 million to $1.2 billion in State funds – an estimated $3.0 to $4.5 billion in all-funds recoveries. The Republican Task Force believes that the target should be even higher and has called for another $300 million increase – translating into an all-funds recoupment target of between $3.6 to $5.4 billion. “There is no excuse for tolerating any fraud in a program that is the fastest-growing and largest single component of state and county budgets,” said Senate Republican Leader Dean Skelos. “Medicaid costs New York State taxpayers a billion dollars per week,” said Senator Kemp Hannon who chairs the Task Force. “This means it is costing taxpayers over fiftytwo billion dollars per year.” The Task Force estimated that as much as $5 billion of the State’s total $52.5 billion in Medicaid expenditures could be “fraud in the system”. Critics of the system frequently cite traditional – if questionable -- estimates that fraud accounts for 10% of all healthcare expenditures (See: “OMIG and the Urban Legend of 10% Medicaid Fraud”, NYNP March 2010.) “This looks like a clear example of retaliation and retribution,” said Johnson. Foley indicated that there were several reasons why, under OMIG’s process for selecting audit candidates, Metropolitan Jewish might have been selected for audits of additional Medicaid services. He stressed that any provider with concerns over the behavior of OMIG auditors should contact him directly.
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April Edition 2010 - New York Nonprofit Press

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