A Massachusetts firm that audited 15 health organizations in New Mexico last year normally gives companies it’s scrutinizing a chance to respond before issuing official findings.
It is a common practice for auditors. Running the findings by staff gives organizations the opportunity to refute findings or address misunderstandings. It’s a way of ensuring the accuracy of an audit, among other things.
A state agency citing potential Medicaid fraud refused to consider documents that could have cleared a health care provider of allegations that it had overcharged the government by as much as $4.3 million, the organization’s officials said this week.
Dear Senators Bill O’Neill and Jerry Ortiz y Pino:
We at New Mexico In Depth were a bit confused - befuddled might be a better word - at your press release yesterday. It bears the title “Media Scrutiny Finally Gives Behavioral Health Debacle the Investigation Warranted” and begins with this line:
Last year, the state’s Human Resources Department said an audit had helped find “credible allegations of fraud” against 15 New Mexico health organizations offering services such as drug addiction treatment and suicide counseling. Though HSD kept the audit secret — from the public and the organizations themselves — the department asserted the audit's findings justified suspending Medicaid funding for the organizations.
The audit the state used to justify suspending Medicaid payments to an Alamogordo health center last year appears to have included mistakenly flagged claims, according to the state Attorney General’s Office.
That raises questions about the process the Human Services Department (HSD) used to ensure the audit was accurate before deciding to suspend Medicaid dollars to the Alamogordo organization.
Many pages of the audit released by the state Attorney General's office were partially or fully redacted. The New Mexico Foundation for Open Government posted the full document online. http://nmfog.org/uploads/PressRelease/cf6b22f5312b412198762483474b1435/PCG_Redacted_Audit_Report.pdf
A portion of an audit released Friday by the New Mexico Attorney General’s Office with many details blacked out shed little light on why the state froze Medicaid payments to 15 New Mexico behavioral health providers.