Good Ol’ Payola for Ernie Fletcher

Fletcher

(Yikes! You’d think the C-J would have a better photo on file.)

The Courier-Journal reported last night around 11 pm (and in today’s edition of the paper) that former Governor Ernie Fletcher’s administration oversaw a Medicaid-reimbursement payment of $3.4 million dollars to Pikeville Medical Center. Now, this ordinarily wouldn’t be that big of a deal, except that the payment came at the tail end of the administration,. Additionally, last week Fletcher was hired as a consultant to the PMC, so of course now it looks pretty fishy:

Records from the state Department for Medicaid Services show that last Oct. 9, the state agreed to pay $3,446,836 in exchange for Pikeville Medical Center dropping its claims for additional reimbursement.

Although 45 hospitals have made similar claims against the state, it was the only settlement reached late in the Fletcher administration and one of only two last year.

The settlements left the other hospitals wondering why they were left out, said Stephen R. Price, a Louisville lawyer who represents 32 of them.

“I’ve been kind of shut out from settlement discussions,” he said. “I’ve had more than one client ask, ‘Why couldn’t we get the same deal?’ ”

Fletcher couldn’t be reached for comment yesterday.

But David Fleenor, who was his general counsel at the end of the administration and is authorized to speak for the former governor, said he sees no conflict between the consulting job and the settlement.

“That (the settlement) was done through the (health and family services) cabinet,” Fleenor said. “That was not done though the governor’s office.”

Even if every aspect of this transaction is above-board, it sure stinks, timing-wise, for Fletcher, who looks bad enough given the budget problems he left for the Beshear administration. Speaking of which, Beshear’s Medicaid commissioner, Elizabeth Johnson, said that settling such claims is unusual:

Johnson said the cabinet’s policy under Beshear is generally not to settle such claims. She said her understanding is that the reimbursement decisions conformed to regulations and that no errors were made in calculating amounts.

She also said that the agreement with Pikeville Medical Center and a $12.8 million settlement in March 2007 with Baptist Healthcare must be paid without the help of federal matching funds.

The federal government, which normally covers 70 percent of Medicaid’s costs, refused to participate in the two settlements on grounds that the original fees paid were consistent with the state’s reimbursement rules, Johnson said.

That means the state, at a time when it is facing severe budget problems, could be solely liable for up to $180 million in claims if the other hospitals prevail, Price said.

I don’t know much about Pikeville Medical Center, but a quick perusal of its humbly-named web site reveals its mission: “to provide quality, regional health care in a Christian environment.” Yeesh. And there’s this little tidbit from the article:

Officials and employees of Pikeville Medical Center contributed at least $16,250 to Fletcher’s primary re-election campaign for governor last year, and at least $14,500 to his unsuccessful general election campaign against Beshear. They also gave at least $14,000 to Beshear in the general election.

Lookin’ good, Ernie!

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