News organizations will try again for health audit’s release

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New Mexico In Depth and the Las Cruces Sun-News are asking a judge to reconsider a ruling that kept secret an audit a state agency used to justify suspending funding for 15 health organizations.

Tens of thousands of New Mexicans in need of treatment for drug addiction, depression and other issues were affected by the New Mexico Human Services Department’s (HSD) 2013 decision to freeze Medicaid funding because their care was abruptly taken over by five Arizona firms in a chaotic transition.

Today, the news organizations filed a motion asking 3rd Judicial District Chief Judge Douglas R. Driggers to order the audit released, saying nearly a year has passed since the state Attorney General’s Office began its investigation of Medicaid fraud allegations levied against the 15 organizations by HSD.

Last November, Driggers agreed secrecy was needed while the AG completed its investigation, which began in June 2013. But the judge said the two news organizations, which had sued to win public release of the audit, could come back in six months to ask him to reconsider his ruling.

Since then, the AG has cleared two of the 15 health organizations of Medicaid fraud and made public portions of the audit, including sections that pertain to those two entities. But hundreds of pages detailing specific findings related to the other organizations remain secret. With investigations of the other 13 organizations ongoing, Attorney General Gary King told the Sun-News editorial board today that, without increased funding, his office’s probe could take “another year or two, unfortunately.”

The news organizations are concerned that, while the investigation continues, “the public remains in the dark regarding the reasons why New Mexico’s mental health care system was turned upside down, affecting tens of thousands of New Mexicans,” according to the motion.

Release of the full audit, which was conducted by the private firm Public Consulting Group (PCG) for HSD, would allow the public to decide whether the freezing of Medicaid funds was justified, the motion says.

While the state must be a careful steward of public money, Sun-News managing editor Sylvia Ulloa said, it must also be open and accountable to citizens.

“We hope that Judge Driggers will rule in favor of the residents of New Mexico, who deserve to know the reason the state disrupted needed services for a very vulnerable population of patients,” Ulloa said.

The payment freeze not only affected New Mexicans in need of treatment. It also caused many of the 15 providers to fold, including The Counseling Center in Alamogordo, one of the two organizations the AG’s office has already cleared of Medicaid fraud.

In addition to saying there was no evidence of Medicaid fraud at The Counseling Center and Northern New Mexico’s Easter Seals El Mirador, the AG’s investigation found much lower rates of potential Medicaid overbilling than the state-ordered audit alleged. As NMID recently reported, the AG investigation calls into question the integrity of the PCG audit.

The Sun-News and NMID have documented the chaotic nature of the transition to the Arizona providers and disruptions in services that resulted in Las Cruces and around the state. La Frontera, one of the Arizona agencies brought in to provide behavioral health services, last month announced layoffs and staff cutbacks amounting to about a 14 percent cut in its workforce since its arrival.

The news organizations hope to win release of the audit so they can do reporting to help New Mexicans understand the allegations against the providers, the reasons the state chose to freeze Medicaid payments, and the fallout of that decision.

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