FBI PROBE SEARCHES FOR CRIMES IN CARE AGENCY; BEHAVIORAL HEALTH DEPARTMENT PROBED.

Byline: David Greenberg Staff Writer

The FBI has launched an inquiry into possible criminal activity related to questionable Medicare billing practices by the Ventura County Behavioral Health Department, officials said Thursday.

The Federal Bureau of Investigation opened its own probe after helping the U.S. Attorney's Office in its civil review of the county agency, which oversees mental health programs.

``We are doing a preliminary investigation to determine whether there is anything of a criminal nature that we should be looking at,'' said Dave Nesbitt, supervisor of the FBI's Ventura office. ``It's not unusual for us to get involved in a case with the money that's involved as in this case.''

Nesbitt refused to divulge details about the FBI's inquiry.

But it apparently dovetails with the U.S. Attorney's Office's investigation of how and why the county used doctors' names and billing numbers to obtain Medicare reimbursements for mentally ill patients who actually were treated by social workers and nurses. The county receives more money if treatment is rendered by doctors rather than other health-care professionals.

Assistant U.S. Attorney Wendy Weiss refused to comment Thursday on the investigation, but county Supervisor John Flynn said he believes it will be unsealed soon.

Also Thursday, a county psychiatrist who claims to be a whistle-blower in the Medicare investigation said officials have retaliated by suspending his wife from her $68,000-a-year job as a Child Protective Services manager.

Dr. Craig Duncan said he contacted federal investigators and turned over documents and information to ensure that he would not be accused of wrongdoing in the Medicare billing fiasco.

``I think it would have been possible that I could get caught up in it if I had not come forward when I did,'' he said. ``The nature of the meetings were to establish cooperation with the intent to solve the (billing) problems and move forward with lawful practices in all areas.''

But Duncan claimed his cooperation in the federal probe resulted in the suspension of his wife, Sandy, who has worked for the county 25 years. She said she was notified June 17 that she was being placed on paid suspension, but was not told why.

She also said she has done nothing to warrant disciplinary action.

Barbara Fitzgerald, director of the Human Services Agency, denied that Sandy Duncan's suspension is related to her husband's actions.

``It is blatantly untrue that this has anything at all to do with any investigation by the U.S. Attorney,'' Fitzgerald said. ``I did not know who the whistle-blower was. I don't think anybody knew. I'm not sure how they can make that claim.''

The Behavioral Health Department was the target of several state and federal investigations after its failed merger last year with the Public Social Services agency.

In an issue separate from the civil and criminal probes, Medicare is threatening to withhold millions of dollars in reimbursements because the merger violated payment guidelines.

The state Mental Health Department also conducted financial and operational audits. And while no financial irregularities were found, the state issued a report that was highly critical of the county's once-model mental health programs.

The county has until next month to devise a preliminary plan for improving its mental health programs.