Members of New Mexico's Behavioral Health legislative subcommittee discovered this week that state officials were considering contracts with Arizona providers before local firms had been notified of fraud allegations.
Some lawmakers are now looking at potential lawsuits because of an audit performed by the firm Public Consulting Group, or PCG. The audit resulted in a freeze of Medicaid funding to 15 local behavioral health providers.
At the hearing Tuesday in Las Cruces, lawmakers heard from a partner in the law firm Williams Mullen that 72-percent of PCG’s audit findings in North Carolina cases were eventually overturned once providers were able to submit additional paperwork.
Representative Howie Morales (D-Silver City) asked PCG’s Thomas Aldridge whether New Mexico firms’ audit results might be different if they had been allowed to submit additional paperwork.
Aldridge also told lawmakers that he was paid to travel with members of Governor Susana Martinez's administration to tour one of the Arizona firms later paid to take over New Mexico nonprofits, saying the trip happened before his company finished the audit. That raised the ire of Senator Mary Kay Papen (D-Las Cruces).
Senator Craig Brandt (R-Sandoval County) asked Aldridge for details on how PCG chose the random samples that were reviewed for the audit and how the firm reached the conclusion that $36-million in Medicaid overpayments were made to providers.
Lawmakers again asked why the state Human Services Department had to search out-of-state for qualified providers, to which HSD's Diana McWilliams responded that the five Arizona firms are competent in regards to ethnicity, geography and age, and that New Mexico's providers will be used for technical assistance.
PCG signed a contract worth more than $3-million paid by New Mexico taxpayers to conduct the audit of behavioral health providers earlier this year. The same firm has also been selected as the contract manager for New Mexico's portal to the Healthcare Exchange beginning in January.