June 2, 2015

AG files Medicaid fraud charges against Carlsbad clinic

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Attorney General Hector Balderas announced Tuesday that his office filed Medicaid fraud charges against an apparently now-defunct health center in Carlsbad.

Health MoneyBalderas’ charges against four employees of Carlsbad Mental Health Center and the center itself revolve around allegedly falsifying documents, knowingly conspiring to commit fraud and stealing more than $20,000 worth of value from non-Medicaid funds.

The employees, Michael Byron Stoll, Noel Clark, Darrill Woodfield and John Bain, each face one second-degree felony charge and nine fourth-degree felony charges, as does Carlsbad Mental Health Center.

From the Associated Press:

“A person who answered to a listing formerly for Carlsbad Mental Health Center says the center no longer exists and she didn’t have any contact information for those still connected with it.”

Balderas, in a statement, said he will  “aggressively defend victims of fraud and abuse by prosecuting providers who violate the public trust.” He adds that his office is currently investigating other Medicaid fraud referrals “to keep pressure on New Mexico medical and behavioral health providers to work honestly on the public’s behalf.”

Two years ago, the state Human Services Department accused 15 of the state’s main behavioral health providers of fraudulently overbilling Medicaid $36 million. These allegations stemmed from an audit conducted by Boston-based Public Consulting Group on behalf of the Human Services Department which didn’t become public until Balderas released it earlier this year.

Though the audit led to the shutdown and takeover of the 15 behavioral health providers—to much public outcry—Balderas’ officer hasn’t charged any of those providers. His predecessor, Gary King, cleared two of those providers of any wrongdoing. Earlier this year, Balderas charged a former therapist with Service Organization for Youth in Raton with fraud.

The state Human Services Department has said that other investigations are still ongoing among those cleared by the Attorney General.

Related stories:

Medicaid director moving to OptumHealth

AG releases behavioral health audit, wants more funds to investigate

HSD responds to release of behavioral health audit

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