Feds should look into mental health shakeup
By Editorial Board
In letters to state lawmakers seeking their help in getting a federal investigation into the mental health shakeup of 2013, leaders of two of the state’s mental health providers alleged that the audit report showing fraud by their agencies had been intentionally tampered with, and that they had been warned ahead of time by insiders that the state was “determined” to put every agency out of business.
In the summer of 2013, the state Human Services Department froze Medicaid funding for all 15 mental health providers in New Mexico, based on an audit that alleged some $36 million in fraud and overbilling. Attorney General Hector Balderas has since cleared all of the agencies of fraud.
The leaders of three of the impacted agencies wrote letters giving their account of the events, which have been passed on by state lawmakers to members of the New Mexico congressional delegation in hopes of sparking a federal investigation.
Shannon Freedle of TeamBuilders said HSD officials removed a line in the original audit that stated consultant PCG “did not uncover what it would consider to be credible allegation of fraud” when they passed the audit on to then-Attorney General Gary King. The change was discovered by Balderas, who was state auditor at the time, she said.
“It seems that tampering with an audit report should be illegal,” Freedle said.
Mark Johnson, president and CEO of Easter Seals El Mirador, said it has a document dated April 2012 from OptumHealth, which oversaw mental health billing in the state, that “indicates our issued 2012 audit from OptumHealth had been tampered with.”
He said there were significant amendments to the original audit, which were made as an attempt to justify the findings.