New Mexico’s Attorney General says one of the state’s largest healthcare providers committed fraud by deliberately underpaying taxes for over a decade by falsifying Medicaid deductions and credits. Attorney General Hector Balderas filed the claim in state court in Santa Fe Tuesday, alleging that Presbyterian Health Plan, Inc. and Presbyterian Healthcare Services filed claims for tax deductions and credits related to Medicaid for above what the company qualified for between 2001 and 2015.The suit refers to Presbyterian’s actions as “systemic and deliberate.”
“When insurance providers break the rules, they must face consequences,” Balderas said in a statement released by his office. “My office is working with the State Auditor to make sure that Presbyterian—and any other companies that engaged in similar fraudulent conduct—are held responsible for the serious injuries imposed on New Mexican taxpayers.”
Meanwhile, a separate audit of premium tax collections continues, State Auditor Tim Keller said in a statement. In a statement to NM Political Report, a spokeswoman said Presbyterian is “confident that we have acted in good faith and with the intent to comply with our legal obligations and responsibilities” and said the company “vehemently reject[s] the allegations made today and we look forward to a positive resolution to this matter.”
“We are genuinely alarmed and surprised by the timing and nature of these allegations,” the emailed statement from Communications Manager Melanie Mozes said. “The premium taxes paid by Presbyterian Health Plan have been audited multiple times by independent firms and state agencies.
The federal government will take a look into New Mexico’s behavioral health services, according to the four Democratic members of the state’s congressional delegation. In a letter last month to Sens. Tom Udall and Martin Heinrich and Reps. Michelle Lujan Grisham and Ben Ray Luján, the federal Department of Health and Human Services Inspector General Daniel Levinson confirmed the upcoming review. “OIG will review the extent to which behavioral health providers are included in the States’ managed care plans and the types of care offered by these providers,” Levinson wrote in the June 28 letter.
New Mexico’s Attorney General signed onto a lawsuit against the head of the U.S. Department of Education over rescinding protections for students who borrow money for college. AG Hector Balderas is one of 19 attorneys general from around the country that sued Department of Education Secretary Betsy DeVos over her actions on the Borrower Defense Rule, an Obama-era rule aimed at protecting students who borrowed money from debt at colleges guilty of misconduct. The attorneys general are asking a court to order the Education Department to enforce the rule. The rule came, in large part, because of the collapse of Corinthian Colleges, a for-profit college whose students had an extremely high default rate on student loans. Heald College, one of the Corinthians College schools, was eventually fined nearly $30 million by the federal Department of Education for misleading statements about employment rates of graduates.
The U.S. Supreme Court denied New Mexico’s petition to hold Colorado responsible for the 2015 Gold King Mine spill Monday, on the court’s last day in session this term. While conducting exploratory cleanup work of an abandoned mine in southwestern Colorado, federal contractors caused 3 million gallons of wastewater to spill from the Gold King Mine. The mine, like hundreds of others in the area, was owned by a private company before being abandoned. The Supreme Court decision to not hear the case was the latest blow to New Mexico’s attempts to hold someone responsible for the spill into the Animas River, which flows into the San Juan River. Last year, the U.S. Environmental Protection Agency (EPA), whose contractors caused the breach, said that under the Federal Tort Claims Act it was not legally able to pay the claims of economic damages caused by the 2015 spill.
This week, a grand jury charged former state Sen. Phil Griego with 22 new criminal counts centering mostly on embezzlement and perjury for allegedly using campaign money for personal use and lying about it. In total, Griego faces 19 new felonies and three misdemeanors. This adds to the nine previous corruption counts Griego was charged with last summer by a district court judge in Santa Fe. Attorney General Hector Balderas’ office is prosecuting Griego. The new charges include 13 perjury counts, each of which are fourth-degree felonies, for lying on several of his campaign finance reports between 2012 and 2015.
Corruption has long been endemic to New Mexico government. And today, even when people ferret out potential problems or ethical lapses, there’s still a significant gap between the laws meant to protect people and the ability or willingness of state agencies to enforce them. In January, for example, conservation groups wrote to the state purchasing agent and director, asking him to look into a political donation from a company with a lucrative state contract. The company had contributed $1,000 to Gov. Susana Martinez’s political action committee during a time when the state’s Procurement Code prohibits political contributions, when proposals are being evaluated for the awarding of contracts. Months passed, and the activists didn’t hear back from the state purchasing agent or from the agency that had issued the contract, the New Mexico Interstate Stream Commission (ISC).
The head of the University of New Mexico Athletics is leaving as the program finds itself the subject of a special audit and under increased scrutiny thanks to fundraising and spending habits. UNM Vice President for Athletics Paul Krebs announced Friday he will step down effective June 30 of this year. Krebs first began his job as athletics director in 2006. As in many states, UNM coaches of high-profile programs—football and men’s basketball—are the highest-paid state employees. Interim UNM President Chaouki Abdallah praised Krebs and noted that he had been trying to leave for some time.
New Mexico Attorney General Hector Balderas announced Tuesday that he will not run for governor next year, ending months of speculation. Balderas, a Democrat, made the announcement in a statement to media where he highlighted work he has done in his first term as attorney general. “It has been an honor to serve New Mexico and I plan on running for re-election next year in order to continue to fight for our state,” he said. In addition to mentioning prosecuting “more than 100 cases of internet crimes against children and human trafficking” and recovering more than $6 million in Medicaid fraud cases in 2016, Balderas noted his more recent efforts against the Trump administration. “Since the November election, my office has a new responsibility—to stand up for New Mexico against President Trump,” Balderas said.
Anti-abortion advocates from across the country held a press conference in Albuquerque Wednesday morning denouncing New Mexico’s flagship university for its fetal tissue donation practices. Among those who spoke at the event were Rep. Marsha Blackburn, R-Tennessee, New Mexico Rep. Steve Pearce, a Republican and Washington D.C. attorney Catherine Glenn Foster. Blackburn, who chaired the controversial congressional Select Panel on Infant Rights, said she came to “join my colleague in the House [of Representatives] and those in New Mexico that have worked on the issue of life.”
The Select Panel released a report in January faulting the University of New Mexico for lacking protocols to “ensure the survival of infants who show signs of life following extraction from the uterus.” It also scrutinized UNM’s relationship with Southwest Women’s Options, an abortion provider that has donated fetal tissue to the university for scientific research. Supporters of abortion rights, as well as minority Democrats in the Select Panel, have dismissed the report and the panel’s investigation for using “McCarthy-era tactics” to conduct “an end-to-end attack on fetal tissue donation and women’s health care.”
Pearce contended that “the laws are clear” and that “we’re simply stating, ‘Do not violate the law.’”
The Select Panel made 15 criminal referrals for its research of abortion providers and educational institutions across the country, including to New Mexico Attorney General Hector Balderas. To date, Balderas has not acted on the referral to his office.
More than a year after Albuquerque Public Schools denied her public records requests related to an incident involving her autistic son, Laura Gutierrez is taking the state’s biggest public school district to court. Her lawsuit, filed last month in Albuquerque’s state district court, alleges APS wrongly withheld public records responsive to requests she made in late 2015. She is asking for the school district to release the records and pay damages for violating the state’s Inspection of Public Records Act (IPRA). Under IPRA, public agencies can be fined up to $100 per day in damages for not fulfilling public records requests if the person who brings the suit can prove damages. “I have decisions I need to make as a parent, and without these records I can’t move forward,” Gutierrez said in an interview.