Commentary: It was Obama’s fault.
That’s pretty much what then-Gov. Susana Martinez told us days after dismantling the state’s mental health system in the summer of 2013. Martinez said she had no choice but to immediately freeze Medicaid funding for all 15 mental health providers in the state. A provision in the newly passed Affordable Care Act meant the state could lose all of its Medicaid funding, hundreds of millions of dollars, if it had credible evidence of fraud and failed to take immediate action.
We just couldn’t take that risk, she said. Not after an audit that had uncovered more than $33 million in alleged fraud and overbilling. She made no mention of the federal waivers that were available.
The audit had been conducted by Public Consulting Group of Boston, which specializes in Medicaid fraud. It claimed that every one of our state’s mental health providers was dirty. We wanted to see the proof for ourselves. And so, the Sun-News joined with New Mexico In Depth, and sued for release of the audit with the help of local attorney CJ McElhinney. But the court ordered that the audit remain sealed, based on the ongoing criminal investigation at the time.
The governor’s office had turned its information over to the Attorney General’s Office for possible prosecution. Which made for an interesting dynamic, given that Gary King, the attorney general at the time, was also the governor’s Democratic opponent in the 2014 election.
The Attorney General’s investigation to untangle the findings of the audit took much longer than the audit itself. It ended nearly three years after the funding was frozen, in April, 2016, when new AG Hector Balderas cleared the last two agencies. The investigation did uncover more than $1 million in overbilling, and that shouldn’t be discounted. But there was no criminal intent, and nothing close to the pattern of fraud that had been alleged in the audit.
“It now falls to the Human Services Department to take timely and appropriate administrative action to resolve this regrettable situation,” Balderas said.
That didn’t happen. Instead, the Human Services Department under Martinez continued to insist that the audit had been right; and the governor continued to portray the heads of the mental health agencies as wealthy CEOs flying around in private planes.
Earlier this month, the office of new Governor Michelle Lujan Grisham announced that settlements had been reached with the local agencies impacted by the shutdown. Families and Youth Inc. and Southwest Counseling Center Inc of Las Cruces; Border Area Mental Health Services of Deming, Silver City and Las Cruces; and Southern New Mexico Human Development Inc of Anthony, NM will share a $10 million settlement with Santa Maria El Mirador of Santa Fe.
William Daumueller of Southwest Counseling Inc., said the original audit had accused them of more than $2 million in overbilling. The subsequent Attorney General investigation found less than $500. He said they could have proven at the time that the audit was wrong, but were never given the chance.
I don’t know what led Gov. Martinez to take the drastic action that she did. I’ve heard speculation as to the pre-arranged contracts with the Arizona providers who took over services in the state, but my best guess is that her prosecutorial instincts took over and she immediately assumed the worst.
Whatever the cause, it should never happen again. Earlier this year, the Legislature passed a bill sponsored by Mary Kay Papen ensuring that no provider can be shut down in the future without due process.
Walter Rubel can be reached at waltrubel@gmail.com.