Fri July 26, 2013
Local Provider Says Arizona Co. Not Certified For Specific Behavioral Health Services
Easter Seals El Mirador, one of 15 providers recently audited and accused of fraud by the state's Human Services Department, provides behavioral health services to hundreds of children in New Mexico.
Chief Operating Officer Patsy Romero said the last time their program underwent such scrutiny, they received a 93 percent compliance rating. Romero remembered this audit seemed compromised from the beginning, something she caught on to when the lead auditor called her up a few days after he and his team had been in her office. “The way they did their audit,” Romero said, “is they came in and they had their own equipment. So we would provide the records and they would scan and upload them. He said the files they had uploaded to their auditors in Boston were corrupted and couldn't be read.”
As a result, Romero said, El Mirador received a zero rating. The organization filed a lawsuit against the state asking that their funds be reinstated, but a judge on Thursday declined to issue an injunction on the funding freeze.
El Mirador has also applied for a good cause exemption that would release their Medicaid funding. For now, their behavioral health program is being taken over by the Arizona agency, Valle Del Sol. Romero has her reservations.
“The agency Valle Del Sol,” Romero explained, “is credentialed with Optum Health but they are not certified to provide the services we provide- behavior management services and treatment foster care.”
It's not clear how this will affect El Mirador clinicians and clients.