TURNERS FALLS — The Gill-Montague Regional School District may be responsible for paying $700,000 in past Medicaid overpayments.

District Superintendent Michael Sullivan has previously brought the issue to the board in April of this year and did so again at Tuesday night’s meeting. The issue involves the district’s Medicaid billing provider, New England Medical Billing, and what the district thought was billable services to students with medical needs. The district did not know that any reimbursable services must be authorized in writing by a nurse or doctor.

The billing company informed the district in April that there was a discrepancy with the reimbursements, and the district would be receiving less than previous years. After that, the district then learned they had been filing reimbursements incorrectly with the billing company since 2011. They then hired a lawyer more specialized in this field to help navigate this process.

During Tuesday night’s meeting, the committee discussed retaining the lawyer. Sullivan said the district is no longer working with the billing company and he is looking at several options going forward.

Sullivan said the district has discussed the situation with officials at MassHealth, the state agency charged with Medicaid reimbursements in Massachusetts and the contractor that works with school districts.

Committee member Heather Katsoulis asked if there is any liability or responsibility on the part of the billing company that the district paid to handle this. Sullivan said that it is unclear at this point but at the end of the day the responsibility is with the district to pay back the money.

Sullivan said it’s premature to say what will happen next, but that he would anticipate a possible payment plan for the district to pay off the amount over multiple years. Additionally, he said the situation is rare, and so it does have the attention of administration at MassHealth, but because of its rarity, they were not able to offer the district a clear path forward until there’s more information.

Sullivan added that the district has turned over all relevant documents and emails between the district and the billing company to the attorney and has already changed the incorrect practices.

Reach Miranda Davis
at 413-772-0261, ext. 280
or mdavis@recorder.com.