State moves to boot provider from Medicaid 

Provider fights back, says it will improve.

The Department of Human Services has issued an order to terminate Gilead Family Resource Center, a mental health care provider based in McGehee, from the state Medicaid program. DHS also ordered that Gilead repay the state $815,807 in improper billings. The company operates seven outpatient facilities across Southeast Arkansas and serves about 425 people, most of them children.

Though the order imposed immediate termination, Gilead won a temporary restraining order in Pulaski Circuit Court that allows it to continue billing Medicaid until the completion of its appeal. Officials with the company have indicated that they will continue to fight the ruling.

“This is very serious,” said DHS spokeswoman Julie Munsell. “The state considers termination to be a last resort.”

Findings of wrongdoing followed a joint audit by DHS's Division of Medical Services, which conducts billing reviews, and by its Division of Behavioral Health Services, which checks for proper treatment. The audit report listed numerous billing irregularities — including insufficient documentation, double billing and misuse of billing codes to get excessive payments.

The audit also found that the company engaged in improper medical practices. It said the company's general practitioner prescribed psychotropic medication to preschoolers without consulting a psychiatrist. The report also states that children were diagnosed with mental illness by social workers and nurses unqualified to make such a diagnosis.

Children at Gilead received diagnoses ranging from attention deficit hyperactivity disorder (ADHD) to more major afflictions such as bipolar disease. According to DHS findings, at least 13 of those major diagnoses were given to preschoolers in contradiction of professional standards. ADHD was diagnosed in at least 60 youths despite evidence suggesting that other considerations were warranted. The findings also state that “127 out of 129 [reviewed] cases certify beneficiaries as seriously emotionally disturbed (SED) or seriously mentally ill (SMI).” Children so designated generally receive medication. 

The audit covered the period from November 2006 to November 2007. Gilead's current owner, Charles S. Gibson II, bought the company in August 2007.

Gibson said he was aware of the DHS audit before taking over the company. “In this business there are always audits,” he said. “It did make us think twice about it, but we had been through numerous audits before.”

Gilead's previous owner was James Chambers, who Gibson said lives in Texas. He could not be located for comment.

Gibson declined to disclose what he paid for the company, but state sources say Gibson's group bought Gilead for around $4 million, with a $500,000 down payment and the rest to be paid from company profits over time.

Gibson said he did some legal work for Gilead before becoming its owner. He also said Lisa Moon, whom the secretary of state's office lists as Gilead's current vice-president, and Stephen Montgomery, listed as its current treasurer, worked at the company for a few months previous to the ownership transition.

In a letter sent to the state in November 2007, Moon wrote that she had been the chief operating officer of Gilead since January 2007, and that Montgomery had been Gilead's CPA for several years. Montgomery said his services until July of 2007 were limited to crunching numbers produced by Gilead's in-house accountant. He added that Moon's capacity as COO was limited and that Chambers called all the shots, regardless of titles.

Gibson acknowledged that he controlled the company for a period covered by the audit, but he argued that his governance was not at fault for any of the wrongdoings found by DHS.



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