In June, 2013, the state Human Services Department moved quickly to freeze Medicaid funding for 15 mental-health agencies in New Mexico following receipt of an audit that alleged millions of dollars in fraud, and turned the investigation over to the Attorney General?s Office.
The pace since then has been far less swift.
Earlier this month, the AG?s Office cleared Easter Seals El Mirador, a non-profit agency from Santa Fe, of Medicaid fraud. Attorney General Gary King said the investigation found $34,126 in improper billings, but no ?actionable evidence of fraud.?
That?s not even in the same ballpark as the $851,000 in improper billings alleged in the audit commissioned by the state that led to the shutdown. And the two people who head the agency told journalists at New Mexico In Depth they have no idea how either figure was arrived at.
The Santa Fe agency was the second one exonerated by the AG?s office. In January, the Counseling Center of Alamogordo was also cleared of fraud charges. Once again, the AG found $19,023 in overbilling, but no evidence of fraud.
Meanwhile, the other agencies, including Southwest Counseling and Families and Youth Inc. of Las Cruces are left to twist in the wind. They and the majority of health care centers in the state have been turned over to an Arizona provider, who recently announced massive layoffs.
And the public remains in the dark, still unable to view the audit that sparked this whole chain of events. King successfully argued in two different court cases that release of the audit would hamper his investigation. That defense loses credibility with each passing day.
Last year, the Sun-News joined with New Mexico In Depth in filing a public records lawsuit against the Attorney General?s Office seeking release of the audit. In November, District Court Judge Doug Driggers ruled in favor of the attorney general, but with an agreement to review the case in six months. We plan to push once again for release of those documents.
Based on the audit, which alleged some $36 million in fraud, the state took the drastic action of freezing Medicaid funding that most of the agencies, including the two in Las Cruces, needed to survive. We already know that some of the numbers in that audit don?t add up with what has been found by the attorney general. It?s time to release the audit in its entirety.
Mental health providers were shut down without due process, without the opportunity to challenge the evidence against them, without even the chance to see the evidence against them. Maybe that was necessary to preserve the state?s federal Medicaid funding, as the Martinez administration argues. The only way the public can form an informed opinion is by reading the audit.
We understand that investigations of this nature are complicated and take time to review thoroughly. But, it is wrong to shield this important information from the public while that ponderous process creeps slowly along.
We encourage King to reconsider his decision to keep this audit secret, and will look once again to the courts for help if he refuses.