New Mexico In Depth
The Medicaid Freeze
In June, Gov. Susana Martinez’s administration decided to freeze Medicaid funding to 15 health organizations after an audit found problems including overbilling and potential fraud and asked the attorney general to investigate. New Mexico In Depth has been covering the fallout. Here’s a timeline of events constructed with our media partner Fronteras Desk:
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 didn’t do that in New Mexico. The results were catastrophic for many of the organizations.
An Oct. 25, 2012 e-mail from an Optum official provides the earliest glimpse of an idea that eventually became reality: bringing in Arizona providers to take over care for tens of thousands of vulnerable New Mexicans. Read it here.
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.
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.
A health organization battling state fraud allegations is accusing the state of acting in bad faith by “improperly withholding” more than half a million dollars in Medicaid funds it contends it is owed.
Trip Jennings, New Mexico In Depth’s executive director, talked about the ongoing effects of last year’s behavioral health transition, efforts to deal with the flood of Central American immigrants into the United States and other issues during last week’s episode of New Mexico In Focus. Click on the headline to watch.
New Mexico asks AG to determine whether Easter Seals El Mirador can bill for certain services. An official at the organization says New Mexico certified it to bill for the services years ago. Why, suddenly, is the billing an issue, she asks.
COMMENTARY: We at New Mexico In Depth were a bit confused – befuddled might be a better word – at your press release yesterday implying the media hasn’t scrutinized the behavioral health situation. We think maybe you’re a little behind on your reading.