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Tuesday, May 3, 2016

Dr. Gary removed from Board of Health

Monday, June 4, 2007

Federal fraud investigator contacted

Citing multiple concerns, most recently and most seriously the sale of the county's Medicare identification number, the Cherokee County Board of Supervisors voted on Friday to terminate Dr. Thomas Gary from his position as chairman of the Cherokee County Board of Health.

Concerns were raised on Wednesday when Gary met with county officials to discuss transition of services, a transition made necessary because, as of July 1, the county will no longer operate a public health department with county employees. Gary stated that he had sold the county's Medicare identification number to Careage Management, Inc., for $1. Careage Management plans to offer some of the services that are being discontinued by the county public health department.

In a related matter, county supervisors, County Auditor Bonnie Ebel and Assistant County Attorney James Tiernan (who will be the county attorney starting Friday) have sought to obtain Medicare documents from Gary but were reportedly informed by Gary that the documents were "lost in cyberspace." An attempt to obtain the bill of sale for the Medicare number was also unsuccessful.

Gary has since left on vacation to California and the Chronicle Times was unable to contact him.

Tiernan advised the auditor and chairman of the supervisors last week that the matter needed to be dealt with and dealt with quickly. Action was taken to freeze payments on the Medicare account. The supervisors met in special session on Friday and approved a letter of termination (published in its entirety under a separate headline).

At the regular meeting of the supervisors on Tuesday, the supervisors, Ebel and Tiernan participated in a conference call with Robert Eps, a Medicare fraud investigator for a multi-state region, operating out of Kansas City, Mo.

Eps explained that the entity that possesses the Medicare number receives payment for whatever services are or have been provided under that account. Eps said that an appointed county official would not have the authority to sell a federal identification number. He said the sale should be regarded as null and void.

"I'm not sure that any federal laws were broken but in terms of common sense governance, this is simply wrong," Eps said.

Eps referred to the actions of the company that purchased the number as naive, comparing the action to buying the Brooklyn Bridge.

Eps said that he will report the matter to the inspector general's office, which is also located in Kansas City.

Following the conference call, Tiernan said he is launching an investigation at the county attorney's level. He noted that some of the Medicare records that "disappeared into cyberspace" are legally required to be submitted as hard copy documents signed in blue ink.

The supervisors have not acted to name a replacement for Gary.

Letter to Dr. Gary

The following is the letter to Dr. Thomas Gary that the Cherokee County Board of Supervisors, acting in a special meeting on Friday, approved for signing by the chairman of the board.

To: Dr Thomas Gary

The Cherokee County Board of Supervisors must have the best interest of the County tax payer and total tax dollars in all of their decisions.

This letter is to inform you that since you are appointed by the Board of Supervisors under IA Code 331.321(1C) and 331.321(30 respectively, the Supervisors have the authority to appoint and remove members of the County Board of Health. Removal must be by written order filed in the Office of the Auditor, and a copy of the order must be sent to the person removed by certified mail. Upon request filed with the Auditor within 30 days of mailing, the removed person is entitled to a public hearing before the Board of Supervisors on the issues connected with the removal. The hearing shall be within 30 days of the date the request is filed, unless the person requests a later date.

The reasons for removal:

1.Serve public health as a whole rather than any special interest group such as Careage Management.
2.Avoid the appearance of a conflict of interest and disclose any potential conflicts to the board; Dr. Gary leasing his building to Careage Management and Kim Rupp as administrator while working for County.
3.Maintain independence and objectivity with a sense of fairness, ethics and personal integrity; contracts canceled without informing the Supervisors of your actions and repercussions. Actions taken without full BOH knowledge or on the agenda for discussion.
4.Concerns that there are no records of Medicare 855 in the PH office -- two supervisors and the county auditor requested this information from Dr, Gary in person on May 24, 2007 -- Dr. Gary went to the public health office and upon his return, informed the supervisors that the documents were not in the office and neither he nor the public health staff knew where the documents would be.
5.Not informed of Cherokee County Medicare number being sold by Dr. Gary and transferred to Careage Management; was confirmed May 24, 2007 to the Supervisor Chairman, County Auditor and Deputy Auditor.
6.Concerns about putting Cherokee County at risk for potential fraud
7.Concerns about the financial oversight of the PH budget
8.Canceling grant without knowledge of BOH and limiting County funding for a two month period.

You are hereby notified that the Board of Supervisors has voted to remove you from the Cherokee County Board of Health effective May 25, 2007.

As is stated, you have the right to a public hearing within 30 days of this mailing.



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