New Mexico Mercury

The Human Services Division (HSD) which funds Behavioral and Mental Health as well as Medicaid has concluded that 15 New Mexico Mental and Behavioral Health Services that have served their communities for decades have been so fraudulent on her watch that only the nuclear option was possible. She plans to shut them down and bring Arizona agencies to the rescue. HSD has no stomach apparently to fix our system if it’s broken, to build New Mexico capacity and grow New Mexico jobs. New Mexico tax revenues will ship off to Arizona. There should be no surprise that this is seen as part of a purely political agenda to privatize the not-for-profit mental health providers in the state.

There is no question that fraud should be rooted out, but it should also be noted that for-profit hospital corporations have been found guilty of millions of dollars in Medicare fraud.  To think that bringing in for-profit management will somehow eliminate fraud is simplistic.  What is needed is intelligent oversight, clear rules, and regular monitoring – the basis of accountable government.   

HSD also admits that this “fraud” has been going on undetected for three years.  The Albuquerque Journal and the Governor have barely commented on this.  The Secretary says she only knew about this in “bits and pieces” – words she used repeatedly at a recent Legislative Finance Committee hearing.  Yet, some agencies, according to her, had 75% of their billing in error and no one knew! These organizations have been paid without question or challenge until HSD suddenly decided they were wrong, and decided the right response was to not just to penalize all agencies but to destroy them.  In fact, neither the public nor the organizations even now have been told what exactly is wrong. 

There is also no evidence that HSD has had the audit company conduct the same test that our agencies were put through on these Arizona “experts”. For an administration committed to transparency and accountability, HSD not only contracted on a no-bid basis with the Boston based PCG group to conduct the audit, they have also selected these external “administrators” to take over New Mexico companies with no real explanation about why they are better.

All not-for-profit health care related agencies should be quaking in their boots.  Who knows when HSD will come knocking on their doors next.  And will HSD sic PCG auditors on the Medicaid health care delivery system? Was this a practice run?  There has been almost no fallout on HSD from this step, so it is clear that this will not end here.