A recent move with state Medicaid money has sent shockwaves through New Mexico's mental health community.
It began with the state attorney general's audit into 15 behavioral health providers in June. From Fronteras Desk partner New Mexico In Depth:
Federal regulations require that the state suspend all Medicaid payments to the providers targeted by recent compliance audits while the Attorney General’s Office investigates, according to HSD and AG officials. Problems the audits identified at the 15 agencies include overbilling, failing to meet documentation and safety standards, and potential fraud.
Representatives of the 15 organizations immediately raised concerns about disruption of service to patients. By July, the clock was ticking. Milan Simonich of the Texas-New Mexico Newspapers Partnership reported that one agency said it had two weeks before it closed.
Roque Garcia, CEO of Southwest Counseling Center in Las Cruces, said his agency was on the brink of closure.
“We’ve been here 50 years. We’ll be out of business within a week and a half — totally closed,” Garcia said in a telephone interview.
His agency has 2,000 active clients and sees about 3,000 in a calendar year, he said.
Simonich reported that as of Tuesday, eight of the agencies have filed an injuction to restore funding in U.S. District Court.
The state hired Boston-based Public Consulting Group to perform the audit, and its investigative procedures have been criticized by officials from the health care centers. The Las Cruces Sun-News reported the agencies have not been allowed to refute the allegations against them.
New Mexico In Depth reported Friday that three organizations have had funding restored, but the state is looking to other out-of-state agencies to provide service.
[New Mexico's Human Services Department] is in the process of hiring several Arizona-based behavioral health firms to pick up the slack and help avoid service disruptions during the AG’s investigation, HSD spokesman Matt Kennicott said. But with the state providing few details on how those providers will help or when they’ll be ready to do so, the suspension of payments to the 12 New Mexico organizations could leave thousands of New Mexicans without behavioral medical services and hundreds of workers without jobs.