Inside Underfunded Special Education Classrooms

Nov 25, 2015 via CC / Creative Commons via Compfight

New Mexico’s Public Education Department lost a case in federal court last month for underfunding state special education programs. And a state audit revealed that the PED should have spent an additional $110-million dollars between fiscal years 2010 through 2012. Some parents and teachers say there’s a shortage of special education staff.

Marisa Demarco / KUNM

After less than two years serving southeastern New Mexico, a behavioral health provider will shutter its programs on March 31, leaving hundreds without services.

What does this mean for Roswell and its courts, which were ordering offenders into treatment there?

Judge Freddie Romero presides over the drug court for juveniles in Chaves County. It’s not what you might imagine. The judge is warm and friendly. The kids who approach the podium with their parents in tow are everyday teenagers—jeans, T shirts, the occasional piercing.

AHealthBlog via Flickr / Creative Commons License

Another Arizona-based behavioral health provider is planning to shut down operations in New Mexico. La Frontera is one of five nonprofits that took over for local providers accused of fraud. Turquoise Health and Wellness announced earlier this year they would close their New Mexico offices on April 1st.

Marisa Demarco / KUNM

It’s his first month as attorney general and on Thursday, Jan. 29, Hector Balderas released the more than 300-page PCG audit that caused 15 behavioral health service providers to have their funding suspended. 

Since 2013, behavioral health providers in New Mexico have waited to see the details of accusations of Medicaid fraud leveled against them. 

  Attorney General Hector Balderas released a 339-page audit by Public Consulting Group that caused the suspension of funding for 15 behavioral health providers in New Mexico.

Read the released audit here.

Arizona firms were hired to provide behavioral health services, and local providers have said they were unable to see or refute the specific fraud allegations against them. 

audit screen shot

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.

Rubén Diaz Alonso via Flickr

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. 

Robin Zielinski / Las Cruces Sun-News

Two news organizations are asking the N.M. Court of Appeals to overturn a ruling allowing last year’s audit of 15 health organizations to remain secret.

Judge Rules Health Audit Can Remain Secret

Aug 14, 2014
Yuri Yu. Samoilov via Flickr / Creative Commons License

A state agency can continue to keep secret most of an audit it used last year to suspend funding for 15 health organizations and spark criminal investigations into potential Medicaid fraud, a judge ruled Thursday.

The ruling marks the second time in nine months that Douglas R. Driggers, a district judge in Doña Ana County, has agreed with the state’s Human Services Department (HSD) and Attorney General’s Office (AG) that protecting an ongoing criminal investigation trumps the public’s right to information.

The Case Of New Mexico's Altered Audit

Dec 2, 2013

It's been almost six months since the New Mexico Human Services Department (HSD) froze Medicaid payments to mental health providers in the state due to a "credible allegation of fraud."

In June, New Mexico’s Behavioral Health care system was thrown into chaos — the state abruptly froze Medicaid payments to more than a dozen mental health providers in the state after an audit allegedly found widespread

Bryant Furlow / New Mexico In Depth

At the end of June, 15 New Mexico behavioral health agencies had their Medicaid funding frozen by the state's Human Services Department due to “credible allegations of fraud.”

The agencies provide services to approximately 30,000 patients, many who seek help for mental health issues ranging from substance abuse treatment to schizophrenia.

Fifteen New Mexico behavioral health providers that were accused of fraud and shut down still haven’t been able to see the audits that lead to their downfall. The audits supposedly showed the companies over-billed the state for Medicaid reimbursements.