AUBURN - The Cayuga County Mental Health Department is facing possibly hundreds of thousands of dollars in chargebacks from the state as a result of an ongoing Medicaid audit.

The audit, being conducted by the New York State Office of the Medicaid Inspector General, is not complete but county officials are speculating that the county will have to pay a large sum of money from its fund balance.

Legislator Francis Mitchell, R-Genoa, said at last week's Community Services Board meeting that he wouldn't be surprised if the county had to repay the state $2 million.

“This is a conscious effort by New York state to take money away from all the counties,” he said at the meeting.

Mitchell later said that he was speculating about the $2 million figure and that in reality, the county may have to pay anywhere from $500,000 to $2 million, but that neither figure would surprise him.

“If the dollars are taken away, they are not available for other things, including buildings and debt services,” Mitchell said. “I don't like it.”

It is too early to attach a dollar amount to the audit, said Katharine O'Connell, Cayuga County's interim mental health director.

“I am not prepared, nor do I think it's appropriate, to 'guesstimate' an amount of fines and findings from the inspector general's office until I have their report and findings in front of me,” O'Connell said. “I don't think it's responsible.”

Chairman of the Legislature Roger Mills agreed.

“It's premature to come up with a number,” he said. “We are likely to have charges but it's too early to guess.”

Whenever there is an audit, it is taken very seriously, O'Connell said. The department will work to correct the findings to prevent them from happening again.

There are ways to bring the county as close to 100 percent in compliance as possible, she said.

“It's good practice, good risk management and good care,” O'Connell said.

Mitchell is also worried about the mental health population in Cayuga County, which he believes is a fragile one. The audit comes at a bad time because the county needs to concentrate on taking care of its mental health consumers.

The audit may make the Legislature and the mental health staff concerned, Mitchell said.

“I don't want to see damage done. I want to see the county take responsibility,” he said. “Cayuga County needs to take care of the mental health

population in the best possible way.”

Mitchell said that the Medicaid audit is part of an initiative started by former Gov. Eliot Spitzer. The audits and fines are going to escalate in all departments within the state, and he believes this is a trend.

“The state is going to get money any way they can,” he said.

However, County Manager Wayne Allen said that there may be other reasons for the audit. Since 1998 or 1999, the county mental health department received numerous citations from the state Office of Mental Health that were not being addressed until recently. Former county director of mental health David Blair retired in February amid a tumultuous relationship with the county Legislature.

Although the state Office of Mental Health reviews did not look at billing, they did examine the paperwork and record-keeping, Allen said.

It is also possible that the county was just unlucky in being chosen for the billing audit, he said.

“It is what it is. We'll see what happens and we'll move forward,” Allen said.

The governor's press office stated that the purpose of the Medicaid audits is to help ensure accuracy and to save the state money.

“The Office of the Medicaid Inspector General was established to identify fraud, waste and abuse within the state's Medicaid system,” said spokeswoman Maggie McKeon in an e-mail. “The recovery of funds from audits conducted by OMIG are intended to produce savings to New York state and its counties.”

Health and Human Services chairperson Ann Petrus believes that the audit will negatively impact the community, she said.

“I'll be surprised if they don't charge something and that (chargeback) will always have a burden,” Petrus, R-Brutus, said. “We will do what we need to do and ask what we need to do to make this financially easier on the people.”

Like Mitchell, Petrus is concerned because she doesn't want mental health consumers to think that the burden will be placed on them, she said.

Once the county receives the audit results back from the state, it will be able to negotiate the amount of the chargeback.

“The county can mitigate or negotiate and make an argument why you shouldn't be penalized. And I know the county will do that,” Allen said. “We'll keep our fingers crossed that it will not be a large sum of money.”

Staff writer Gitana Mirochnik can be reached at 253-5311 ext. 237 or gitana.mirochnik@lee.net