What's up with the Gaffneys and Medicare?

[sheclown]

Didn't this happen to CM Johnny Gaffney 8 years ago?

News / Metro

Nonprofit led by Reginald Gaffney reaches Medicaid settlement with state
Posted: June 18, 2013 - 6:58pm  |  Updated: June 18, 2013 - 7:23pm
J
View this story on the All-Access Members site
By David Bauerlein   

Community Rehabilitation Center — the Jacksonville nonprofit led by Reginald Gaffney — has agreed to repay the state about $336,000 the center received in Medicaid payments over a 2½-year period.

The settlement amount is considerably less than the almost $1.4 million identified in March by the state Agency for Health Care Administration.

Gaffney, who served five years on the Jacksonville Port Authority board until the Senate did not confirm his reappointment in May, said the settlement allows the center to move past the audit and focus on treating clients.

"I'm excited about ending this because it was very stressful for the agency," he said Tuesday.

State Sens. Aaron Bean and Audrey Gibson joined Gaffney in an April meeting with AHCA Secretary Elizabeth Dudek to discuss the audit. Bean and Gibson have said they were concerned about the audit's impact on the center providing mental health services.

AHCA spokeswoman Shelisha Coleman said Tuesday the agency routinely meets with lawmakers about "constituent issues." She said Bean and Gibson "did not ask that anything special be done, but asked that we do the right thing."

"Each case stands alone, and we give all providers an opportunity to provide additional documentation and to discuss audit findings and methodologies," she said.

A preliminary audit originally pegged the Medicaid overpayments at $2.6 million. After getting documentation from the center, that amount dropped to $1.5 million when the final audit report was done last October. AHCA amended the amount to $1.38 million in March and lowered it again recently after getting additional documentation and explanation, according to the settlement agreement.

At the center's request, AHCA will give training to the center's staff about how to properly document services that are billed to Medicaid.

Gaffney said the center is moving to a computerized record-keeping system and has made changes in management since the period covered by the audit, which analyzed Medicaid billing from September 2008 and February 2011.

"We want to get better," Gaffney said. "I think I've got the best team and staff that I've had in 20 years. It's always my intent to improve documentation."

In addition to repaying Medicaid in the amount of $336,209, the center will pay a $33,620 fine and $3,120 for AHCA to recover its investigative costs. The center has already paid $110,1179 and will pay the remainder in monthly installments over a three-year period.

The center receives about $2 million a year in Medicaid funding. Gaffney said the center will seek to increase its fundraising to cover the cost of the Medicaid reimbursements. He said the agency laid off five employees last month to cut expenses, but the personnel cuts did not reduce the number of workers who directly give care to clients.

David Bauerlein: (904) 359-4581

Read more at Jacksonville.com: http://jacksonville.com/news/metro/2013-06-18/story/nonprofit-led-reginald-gaffney-reaches-medicaid-settlement-state#ixzz2bNI3rfo8

[sheclown]

yeah.  Here it is.

Council candidate airs errors


By MARY KELLI PALKA
The Times-Union,

A Jacksonville City Council candidate reimbursed the state pay almost $132,000 three years ago after being charged with Medicaid provider fraud.

Now Johnny Gaffney wants to get the word out that he's sorry for his past actions and wants to focus on issues during the upcoming campaign.

Gaffney, 46, was arrested on March 2, 2004, and accused of submitting claims to Florida's Medicaid program for services he didn't perform or that weren't authorized.

The State Attorney's Office dropped the charges a few months later. The court file in the clerk's office didn't provide details about why the charges were dropped. The assistant state attorney involved in the case couldn't be reached for comment.

Gaffney, a Democrat, contacted the Times-Union Tuesday after his legal problems hit at least one local online forum. He said he wanted to make sure the public knew about the charge, and he didn't want his opponents to be able to use the information against him to hurt his campaign.

He's running for District 7, which includes parts of downtown and East Jacksonville. The seat is being vacated by Pat Lockett-Felder.

From Dec. 1, 2002, through Sept. 30, 2003, Gaffney misrepresented himself as a licensed provider of support services for an adult day care program, according to a report by the Florida Agency for Health Care Administration and Medicaid Fraud Control Unit.

The program, Community Resource and Training Services, was located on the Northside and taught life skills to six or seven mentally or physically challenged clients at a time. He repaid Medicaid almost $132,000, according to the state report.

Gaffney said he didn't know he needed a license to seek payment from Medicaid. He said he made a mistake and no fraud was intended.

"I'm very sorry," he said.

Gaffney said he now works as an adjunct professor for the Jacksonville campus of the University of Phoenix.

His brother, Donald Gaffney, is a former city councilman and a state representative who served two years in prison for a 1998 federal mail fraud conviction.

Also in the race for District 7 are Democrats Carolyn Anderson, Kenneth Arnold, Irvin "Pedro" Cohen, Marc A. McCullough and Martha C. Valdes-Pellino, and Republican Gary C. Morrison.

Gaffney had raised about $22,000, more than any of the other candidates, according to his last campaign finance report.

William Sweet, a former candidate for the District 7 seat, dropped out of the race in October after being accused of stealing about $8,700 of taxpayer money while working for the city.

mary.palka@jacksonville.com, (904) 359-4104

[ChriswUfGator]

Wait so the guy who worked with spar to crack down on group homes, owns group homes?

Naturally. This is Jacksonville...

[Cheshire Cat]

The question is soon to become "What is up with the Gaffney's and Federal Housing Funds and the plans to put a Gaffney back in control of district 7?

[Cheshire Cat]

This is another piece from the TU.  Amazing how you can overbill a state program for $1.4 million and only pay $111,000 in fines while the non profit used to bilk the funds stays open along with other "non profits" run by the same man?

By David Bauerlein   

A nonprofit run by former Jacksonville Port Authority board member Reggie Gaffney overbilled Medicaid by almost $1.4 million, according to an audit by the state Agency for Health Care Administration.

The state is seeking to recoup the money from Community Rehabilitation Center and also assess a $111,000 fine.

Community Rehabilitation Center disputes the state's audit and says it filed for an administrative hearing to make its case.

Gaffney, whose five-year tenure on the port board ended this month after the Florida Senate did not confirm his reappointment, helped found Community Rehabilitation Center in 1993 and serves as executive director.

The nonprofit helps low-income people by providing medical services for mental illness, substance abuse and HIV/AIDS.

Gaffney did not return a call for comment.

An email from his assistant said the organization disagrees with the audit.

Community Rehabilitation Center "requested a formal administrative hearing upon receipt of AHCA's audit advice and we are in the process of actively negotiating resolution of this matter," the email said.

The billing case stems from a routine audit by the Agency for Health Care Administration. Last July, a preliminary audit determined the Medicaid program overpaid Community Rehabilitation Center by almost $2.6 million from September 2008 through February 2011.

After further review, the state put the amount of overpayment at almost $1.4 million "for services that in whole or in part are not covered by Medicaid," according to a letter sent to the nonprofit in March.

The letter says Community Rehabilitation Center failed to adequately document its medical records, lacked a valid plan of care for some home health services, and did not render some medical services that were listed on claims for Medicaid payments.

Agency for Health Care Administration spokeswoman Shelisha Coleman declined comment, saying the agency does not discuss cases in active litigation.

In the 2011-12 fiscal year, the agency conducted 2,842 audits statewide and found overpayments in 1,987 cases, according to the agency's annual report. Those cases totaled $36 million in overpayments, or an average of roughly $18,000 in overbilling per case.

Community Rehabilitation Center has reached settlements with the state in the past over Medicaid audits that found overbilling. The organization agreed to pay about $29,000 in 2003 and paid $390 in 2010, according to state records.

Gaffney's service on the JaxPort board ended when the Senate wrapped up its session without voting to confirm his appointment by Gov. Rick Scot

Read more at Jacksonville.com: http://jaxairnews.jacksonville.com/news/metro/2013-05-16/story/state-reggie-gaffneys-nonprofit-overbilled-medicaid-nearly-14-million#ixzz2bWkRcoJJ

[Noone]

All the above is positive? I guess.  So in Springfield with the recent Meeks land Bonanza announcement.
Recent legislation.
2013-377- Waiving of fines.
2013-373- Regulatory Compliance Coordinator
2013-384- Hogans Creek
When is the first candidate forum for Dist. 7? Instead of questions will it be depositions?