Last week, New Mexico State Legislators met with the Attorney General’s (AG) Office and the Office of the State Auditor (OSA) to speak about the ongoing investigation of an audit performed earlier this year alleging fraud amongst 15 non-profit behavioral health providers throughout the state.
Currently, only two of the providers have had Medicaid funding restored in congruence that they pay back the state about $4.2 million. When representatives from the AG’s office and OSA were asked why the remaining 13 providers were not given the option to participate in the same agreement, both offices could not answer, stating that the decision was made completely by the state’s Health and Human Services Department, which did not have a representative present at the meeting.
“The main point here is that the other 13 providers were not given the opportunity to respond, in vivid contrast to these two providers. There was no due process afforded to them, no courtesy of an exit audit review, no good cause exception granted. They still have no idea what the flagged problems are in the audit,” said State Senator Bill O’Neill (D-13-Bernalillo), who has been an outspoken advocate of the behavioral health organizations affected. “But by now, it is too late, sadly, for many of these community based New Mexico providers. This is unacceptable, especially if we ultimately learn that many of the problems were clerical in nature,” he added.
During the meeting, several subject matter professionals spoke to the legislative subcommittee about how the disruption in care has affected clients. Some private citizens who use services also spoke to the detriment that the interruption has caused for them and their family members.
“Our concerns are about those who are in need of these services and how we can get answers quick so that we can get closer to supplying the demand,” State Senator Tim Keller (D-17- Bernalillo) said. “Mental health issues should not be taken lightly and behavioral health providers must have the support needed to take care of their clients. Going forward we have to address the structural lack of oversight on all our contracted health services. Furthermore, the administration simply cannot be permitted to do an end around the procurement code and give away no bid out of state contracts.”
“We could very well end up with honest New Mexico businesses being replaced by large out-of-state Arizona firms. One such affected mental health provider has been in operation in my district for over 40 years. It is now history. What kind of leadership is this? I call it myopic at the very least, and potentially downright mean-spirited,” said O’Neill.
According to the AG’s Office, the investigation of the audit will be on-going. No deadline for the investigation has been set because of the large amount of paperwork needed to be reviewed.