As Gilda Radner’s Emily Litella might have said, “Nevermind!”
More than four years after accusing Southwest Counseling Center of overbilling the state by $2.8 million in Medicaid reimbursements, the Human Services Department has settled with the former Las Cruces behavioral health provider for $484.87. SWCC was one of 15 health organizations accused of overbilling and potential fraud by Gov. Susana Martinez’s administration in 2013. The state suspended Medicaid payments to the organizations pending an investigation, and outsourced behavioral health contracts to five Arizona companies, which effectively crippled the network of New Mexico behavioral health providers. All the while, the state kept an audit they used to justify the move secret, making it impossible for each organization to know what they were being accused of specifically. See a timeline and read of coverage of the Medicaid freeze here.
Tens of thousands of Medicaid recipients in New Mexico are not receiving their health benefits on time, according to numbers from state government. As of February of this year, more than 48,000 Medicaid cases up for renewal are not being processed by the state Human Services Department (HSD) on time, according to a federal court filing in April citing HSD’s own numbers. And that number of Medicaid renewal delays has only grown to more than 59,000 as of May 10, according to Maria Griego, a staff attorney with the New Mexico Center on Law and Poverty. “They’re pretty bad,” Griego said of the delays. While the number of New Mexicans who haven’t received their Medicaid benefits on time has been expanding, HSD erased a large part of the backlog of renewal applications for the federal Supplemental Assistance Nutrition Program (SNAP), formerly known as food stamps.
Last month, 82-year-old Viola Weir received a letter from the state that rejected her request for Medicaid benefits to pay for nursing home care. The letter from the New Mexico Human Services Department (HSD) said she had not provided the state agency with “the mandatory documents we need to decide if you can get benefits.” As a result, the department denied Viola Weir her Medicaid benefits. The very same letter also said her income levels and assets met the qualifications to receive such care. That’s according to documentation that Tom Kovach, Weir’s son-in-law, sent to NM Political Report from HSD, the state department which processes federal benefits. To Kovach, the letter didn’t make sense.
Lawrence Martinez says driving triggers him back to the dark days of dependency. “Monday was my first day driving the car,” the Albuquerque father of four said last week, talking about the car he and his wife recently bought, as he sat in a conference room at Albuquerque’s Turning Point Recovery Center. “That was an issue on its own, but it’s working out now. Leaving the house, I get anxiety. Once I get on the road, it’s perfect.”
Martinez has been recovering from a methamphetamine addiction since last July.
When state Human Services Secretary Brent Earnest goes before lawmakers to speak about his budget for the Medicaid insurance program, many want to run for cover. One year, he needed as much as $100 million from the general fund to fully pay for all the new enrollees under the federal Affordable Care Act and provide the same level of service. Last fall, he said he needed another $80 million for the fiscal year that begins July 1. On Thursday, he told the House Appropriations and Finance Committee that request had dropped to $42 million. “This is a significantly better picture than you saw in the fall,” Earnest said.
The state wants to extend a waiver that allows the state to waive work requirements for federal food benefits. The Santa Fe New Mexican reported the news of the proposed waiver coming from the embattled state Human Services Department. The department previously sought to reimplement the work rules for the Supplemental Nutrition Assistance Program, or SNAP, but a federal judge blocked the request. Earlier this year, a federal judge slammed HSD for doing the work of creating new rules and procedures for the work requirements while not working toward compliance with a decades-old consent order. Last week, a federal judge named a Texas administrator as a “special master” to oversee the department’s food benefits functions.
NM Political Report senior reporter Joey Peters and reporter Andy Lyman sat down to talk about what we covered this week and what to expect next week. The two reporters talked a little about what a Trump presidency might mean for New Mexico, especially in terms of a new BLM rule and marijuana. They also recapped Peters’ coverage of the state’s Human Services Department leading up to the new special master announced Thursday and the fact that Gov. Susana Martinez is no longer chair of the Republican Governors Association.
A federal judge appointed a Texas government official to serve as the “special master” to help a New Mexico state agency come into compliance with federal law. Lawrence M. Parker, who has worked for the Texas Health and Human Services Department, will be responsible for essentially fixing the New Mexico Human Service Department’s food aid and Medicaid case processing. The appointment comes as part of a decades-old lawsuit that alleged HSD wasn’t properly processing federal aid to New Mexicans. While that lawsuit, known as Hatten-Gonzales, resulted in a consent decree in 1990, an Albuquerque-based nonprofit argued in court this year that the state wasn’t properly following guidelines laid out under the consent decree. The New Mexico Center on Law and Poverty also argued for the federal court to appoint an independent monitor to oversee the state department’s Income Support Division, which processes Medicaid and Supplemental Nutrition Assistance Program (SNAP) benefits.
The state and federal government have “ramped up their investigations” of the New Mexico’s alleged widespread falsification of food aid applications, according to the union that represents the state’s case processors in the Human Services Department. And the American Federation of State, County and Municipal Employees, or AFSCME, Council 18 question whether investigators are targeting “frontline workers” more than the administrators at HSD for responsibility in the scandal. An online post from AFSCME also claims that the investigation is criminal and advises all union members to “contact your union representative before participating in any interview.”
“We understand the importance of getting to the bottom of this swamp,” the AFSCME post reads. “It will be unacceptable should frontline workers be scapegoated of held responsible for wrong-doing [sic] that federal court proceedings revealed was directed from top levels of state government.”
Reached by phone, representatives from AFSCME declined to comment on the matter further. A spokesman from HSD also didn’t return requests to comment Tuesday afternoon.
A federal judge ordered New Mexico Human Services Department Secretary Brent Earnest held in contempt of court for failing to comply with orders in a long-running food aid case. The order from U.S. District Court Judge Kenneth Gonzales came down on Tuesday afternoon. The contempt order came in civil court. “It’s extremely rare for department officials to be held in contempt by federal court,” Sovereign Hager of the Center on Law and Poverty explained. “It’s a very bad and serious thing, especially for low income people who need these programs to live.