Patients of a Hilo physician filled the courtroom Tuesday, eager to hear Hilo Circuit Judge Greg Nakamura acknowledge the doctor’s service to the community.
“Nobody else would take me,” said Thera Owens of Hilo, who, through tears, identified herself after the hearing as one of Dr. Frederick Nitta’s patients. “He saved my life. He saved my daughter’s life.”
Nitta is challenging the state Department of Human Services, which ruled he was overpaid more than $200,000 for services to Medicaid patients.
The Affordable Care Act includes a provision for “enhanced” payments to certain types of physicians, such as those who treat impoverished patients.
A member of Nitta’s staff sent in an application for the enhanced payments — and Nitta’s practice received payments from insurance companies that totaled more than $200,000 as a result .
This isn’t the first time Nitta and the DHS have clashed in court. In a 2014 case, DHS accused Nitta of fraud and withheld Medicaid reimbursements to his medical practice.
In that case, a state hearing officer found the suspension of payments to Nitta was unjustified and that Nitta hadn’t committed fraud because Nitta’s office had been given an incorrect billing code for making insurance claims.
The state attorney general’s office appealed to Hilo Circuit Court, where Nakamura — the same judge hearing the current case — upheld the hearing officer’s decision.
During the time when Medicaid payments were withheld, Nitta essentially kept his practice viable by paying staff out of his own pocket until the case was resolved.
Now, Nitta’s attorney, Eric Seitz, raises an eyebrow about why Nitta is the only physician in Hawaii being singled out by DHS as allegedly being overpaid for Medicaid claims.
A representative of the state attorney general’s office told Nakamura on Tuesday that Nitta wasn’t even aware he was in the enhanced payments program until the state wanted money back.
Seitz said Nitta provided patient records for review so it could be shown that Nitta is a “primary care physician.” But the state wouldn’t look at those records, citing patient confidentiality. The state contends Nitta’s practice is focused on obstetrics, not primary care.
But Seitz said an independent auditor hired to review Nitta’s patient records found that more than 60 percent of his patient services indeed qualify as primary care. Seitz said Nitta would accept an independent audit to prove it.
Nakamura said he would review the case and issue a ruling later.
In the meantime, Nitta’s patients worry.
Owens said Nitta considers patients family. He helped her withdraw from the 14 medications she was taking and now she’s down to just a single dose of blood-pressure medicine.
“I would not have been able to do it without him,” she said. “He truly is my saving grace because if they rule that he is not a primary care physician, I have nobody else to turn to.”
Jody-Rae Bergfeld, a registered nurse who works for Nitta, said she once was one of his patients.
“He’s a great guy doing great things for this community,” she said. “He’s not just one of the best OB/GYNs in town, he’s a great primary care doctor. My big concern is for the women that Dr. Nitta cares for.”
She questioned whether he’s come under scrutiny “because he serves women, poor women.”
“I trust him with my life,” she said.
Email Jeff Hansel at jhansel@hawaiitribune-herald.com.
