The New Mexico Foundation for Open Government has filed a lawsuit seeking public disclosure of an audit that identified potential overbillings and fraud by providers of mental health and substance abuse services.
The Human Services Department has frozen payments to more than a dozen behavioral health providers because of the fraud allegations.
When Medicaid funding for 15 of New Mexico’s behavioral health providers was frozen earlier this summer, lawmakers began hearing from their constituents.
Senator Tim Keller says people in his district in southeast Albuquerque are extremely upset. Now Keller has drafted a piece of legislation he hopes will prevent this kind of situation from happening again.
The state expects about half of the 400,000 uninsured New Mexicans to purchase insurance through the state health insurance exchange when it’s fully implemented in 2014. A new study by the Kaiser Family Foundation finds New Mexicans will pay some of the lowest rates in the nation.
"The age group that will face the highest increases is actually older individuals, 64 year olds in New Mexico will see a 159% increase in their rates to $494 a month and similarly women will see a 160% increase in their rates," says Avik Roy with the Manhattan Institute for Policy Research.
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.
Protestors gathered at the state capital in Santa Fe today, pleading with Governor Susana Martinez to change course and end the chaos now hampering New Mexico’s behavioral health system. Front-line workers who treat extreme cases of the mentally ill reported losing touch with their clients after five Arizona firms took over operations at 12 local providers.
Federal authorities heard directly Wednesday from more than two dozen behavioral health clients concerned about the continuing disruptions of services in New Mexico. Callers were highly critical of the state's move to freeze Medicaid funding for providers suspected of fraud. One after another, men and women, adult patients and parents of children recounted problems getting services.
This week marks the beginning of new management for another one of the New Mexico's nonprofits under investigation for alleged Medicaid fraud. Three out of four of the counselors who treated patients at Valencia Counseling Services in Los Lunas are no longer working there, and that has the new management team on edge.
Often, redacted documents might look like this, with blurred or darkly marked segments. But according to The Albuquerque Journal, the redacted Audit Protocol documents they received were so heavily redacted that 8 of 13 pages were entirely blank.
Governor Susana Martinez’s administration is moving ahead - despite objections from state legislators - with plans to use more than 10-million dollars from the Human Services Department to pay Arizona contractors that are taking over New Mexico’s Medicaid-funded behavioral health operations. The Legislative Finance Committee voted 15 to 1 on Wednesday to reject the budget transfer.
More than 300 people in 37 states have been infected by salmonella, many of which were children. Investigators have linked the source of the outbreak to a chicken, duck and turkey hatchery in Eastern New Mexico.
In the Southwest, nine people have been infected in California, eight in Arizona, 19 in New Mexico, and 32 in Texas.
Originally published on Tue August 20, 2013 4:58 am
DAVID GREENE, HOST:
In the American Southwest, a rare genetic disorder known as the Common Hispanic Mutation has haunted those of Spanish descent for nearly 400 years. It's been called "El Frio," or the cold. Now, to understand the disease, researchers in New Mexico are digging into the genetic history of residents. From member station KUNM in Albuquerque, Tristan Ahtone reports.
There are still a lot of questions about the New Mexico Human Services Department's abrupt halt of Medicaid funding to 15 behavioral health providers and the state's contracts with Arizona firms to take over provider management.
According to the CDC, excessive alcohol consumption, primarily binge drinking, poses a huge public health problem across the country. Major economic impacts include police responses to violence and treatment of health problems related to alcohol.
Rio Arriba County health officials hosted their first-ever Twitter Town Hall today - A panel of experts answered tweeted questions about Medicaid. The twittersphere was abuzz with questions about the state's recent audit of behavioral health providers.
The state Human Services Department has run into a roadblock with the contracts it signed with five Arizona providers who are taking over management of behavioral health services in New Mexico. The Legislative Finance Committee has delayed transfer of funds to pay for the out-of-state firms’ contracts, but the Arizona contractors still have an obligation to provide services to behavioral health clients.
Originally published on Thu August 8, 2013 4:56 pm
On a blisteringly hot summer afternoon, about 40 people gather at the Evangelico Cemetery in southwestern Albuquerque. Deacon Pablo Lefebre leads the service and begins with a prayer
"Because God has chosen to call our brothers and our sisters from this life to himself," he says, "we commit their bodies to the earth, its resting place. For we are dust, and to dust we shall return."
This isn't your average funeral. The light gray casket about to be lowered into the ground is filled with the cremated remains of 87 county residents.
New Mexico behavioral health providers who had their Medicaid funding frozen after allegations of fraud and mismanagement are in the process of transitioning to management from several Arizona contractors.
Meanwhile, Valencia Counseling Service, a facility south of Albuquerque, is holding out for a last minute reprieve from an Albuquerque District Court.
There’s been a lot of uncertainty about what new management by out-of-state firms will mean for behavioral health providers in New Mexico. Thursday morning on the KUNM Call In Show some of that uncertainty was dispelled by Diana McWilliams of the state Human Services Department .
New Mexico's Human Services Department recently accused 15 of New Mexico's largest Behavioral Health Care providers of Medicaid fraud, after results from an audit aroused suspicion. Providers have had their Medicaid funding frozen, and many have been forced to turn over their case loads to Arizona companies. The audit has been released to the Attorney Generals office for a full investigation. Recently AG Gary King announced that his office was fast tracking the investigation. He spoke with KUNM's Rita Daniels to explain just what exactly that means.
Many clients of the providers who've had their funding frozen are considered some of the most fragile residents of the state. Gay Finlayson's son Neil was diagnosed with schizophrenia when he was 20. Doctors told the family it was one of the most difficult mental health conditions to treat.
Behavioral health clinicians have direct contact with their clients in a trusted relationship. Joe Frechen is a psychiatrist who's been treating people for drug addiction and suicide prevention for 20 years in southern New Mexico. He works on contract with many current providers and wants to continue that arrangement.
Frechen says he’s concerned that the patients he sees at clinics that have had their funding frozen won’t get what they need from out-of-state contractors hired by the Human Services Department.