Mackinac County is on the hook for over-billing to Medicare through the Luce, Mackinac, Alger, and Schoolcraft (LMAS) Health Department, an amount that could add up to $400,000, pending the results of an ongoing, two-year investigation. The problem has spurred Mackinac County commissioners to propose a split from the four-county agency, even though doing so will not absolve it of its obligations under LMAS.

The Mackinac County Board of Commissioners will hear public opinion on a proposal to separate the county from the Luce, Mackinac, Alger, and Schoolcraft (LMAS) Health Department and create a single county health department during a public hearing Wednesday, November 4. The hearing will take place at 6 p.m. on the third floor of the Mackinac County Courthouse in St. Ignace.

Two Mackinac County commissioners serve on the LMAS board, Dawn Nelson and Calvin "Bucky" McPhee, providing the county's oversight of the health department. Commissioners also serve from the other four counties.

Mrs. Nelson, who also chairs the Mackinac County Board of Commissioners, said the health department has been beset with financial problems, a reason for the proposed split. For example, she noted, the county paid about $18,000 to LMAS last year, but will have to pay $84,000 this year.

Mr. McPhee said a contributing reason for the Medicare predicament was the billing practice LMAS was engaged in about two years ago. When a patient receives home health care services, they are supposed to be assessed every 60 days to determine if they still require the service. The health department was not performing those reassessments, Mr. McPhee said, and continued billing for them.

Medicare conducted an audit and discovered the discrepancy and is requiring the department to pay the money back. Mr. McPhee does not know how much Mackinac County will be responsible for because the audit of patients who received home health care is ongoing. He believes the amount may range between $300,000 and $400,000.

"All four counties will have to share the problem," Mr. McPhee said.

He said more details about the situation will be released by him at the hearing next Wednesday. Presumably that will include the commission's estimated cost to sponsor its own health department and the steps commissioners would implement to ensure financial and fiduciary oversight in the future.