NM’s AG releases a redacted mental health audit

October 19, 2013 • State News

SANTA FE, N.M. (AP) — State Attorney General Gary King has released part of an audit that led to a shakeup in New Mexico’s mental health system, but most of the details are redacted.

The Santa Fe New Mexican reports ( the report confirms a criminal investigation into Medicaid billing fraud is ongoing. But virtually all specific in[auth] formation about the 15 New Mexico providers audited in search of possible financial fraud is blacked out.

In a state court filing, King said releasing the rest of the information could jeopardize the investigation. He asked for a judge to review the complete audit privately and then determine if releasing additional sections or pages is appropriate.

“The withheld portions of the audit are precisely that — evidence in connection with the criminal investigation that the AG received from an outside source,” King said. “The substance of the document contains confidential sources, methods, information and evidence received or compiled in connection with a criminal investigation. To require public disclosure of that information would fatally undermine the law-enforcement exception, as it would unduly interfere with the ongoing criminal investigation.”

The audit was released Friday in response to a lawsuit filed by the New Mexico Foundation for Open Government.

Officials with the New Mexican said the newspaper received a copy in response to a request under the state Inspection of Public Records Act.

New Mexico’s Human Services Department suspended the Medicaid funding for the providers after the February 2013 audit commissioned by the state and Optum Health, the company under contract to provide behavioral health services in New Mexico. The state maintained the audit uncovered “credible allegations of fraud.”

Only one of the providers had its funding completely restored, while several others were forced out of business. Their caseloads of some 30,000 patients were taken over by Arizona providers, contracted by the state to continue services during the investigation.

For months, the Human Services Department and Gov. Susana Martinez said auditors uncovered $33.8 million in Medicaid overpayments between 2009 and 2012.

That’s more than 13 percent of the total payments the providers received from Medicaid, a government insurance program for the poor and disabled that is managed by the state.

Related Posts

Leave a Reply

« »