May 11, 2016

Legislators want DOJ to probe behavioral health shakeup

Matthew Reichbach

Senate Majority Leader Michael Sanchez speaking to reporters after the legislative session.

New Mexico legislators want the Department of Justice to look into the behavioral health shakeup from 2013 after the state Attorney General found no fraud.

Senate Majority Leader Michael Sanchez speaking to reporters after the legislative session.

Matthew Reichbach

Senate Majority Leader Michael Sanchez speaking to reporters after the legislative session.

Senate President Pro Tem Mary Kay Papen of Las Cruces, Senate Majority Leader Michael Sanchez of Belen, House Minority Leader Brian Egolf of Albuquerque, all Democrats, sent the letter.

The three received letters from providers who had Medicaid funding cut by the state, and forwarded these letters to the three members of the U.S. House and two members of the U.S. Senate from New Mexico.

“The contents of these letters greatly concern us,” the three legislative leaders wrote. “We have also been contacted by constituents, requesting our assistance with accessing behavioral health services over the past two years.”

In a joint response, U.S. Sens. Martin Heinrich and Tom Udall along with U.S. Reps. Michelle Lujan Grisham and Ben Ray Luján said they made the DOJ aware of the “troubling allegations.”

“It’s understandable that New Mexicans want a thorough review of what happened, and for someone to be held accountable for this severe disruption of services and to provide a resolution,” the Democratic delegation wrote. “This is why we are calling this issue to the attention of DOJ, and why we are also building support for our legislation to do everything in our power to ensure this kind of manufactured crisis never happens again.”

The state Department of Health cut off the Medicaid funding for 15 behavioral health providers, citing “credible allegations of fraud.” The department had other options, but went with the most drastic.

Many providers closed their doors before being clear of fraud. The state continues to insist because of overbilling from the providers, the Medicaid funding will remain frozen.

One of those providers that wrote to the legislative leaders was Mark Johnson, the CEO of Easter Seals El Mirador. He outlined the process of when the company, which he refers to as ESELM, faced a “takeover” from HSD and Valle del Sol.

“Due to this hostile takeover by HSD and VAlle del Sol, ESELM was forced to lay off 130 employees as the majority of the employees refused to go work for an out of state provider,” Johnson wrote. “Not one single credentialed clinician transitioned to Valle Del Sol.”

Johnson said the provider had eight full time clinicians before the “takeover.”

Southwest Counseling Center CEO Roque Garcia wrote that he faced backlash after he spoke out against the behavioral health shakeup.

“Completely false information was passed on to the news media and the news media only fact-checked what they wanted,” he wrote. “Much of the information was blatantly false. For example, they kept saying that SWCC had lent me Medicaid money to buy an airplane. This was not true. They never mentioned that toward the end of June 2013, I had personally been frozen, so that we could meet payroll for SWCC.”

A spokesman for the governor’s office did not respond to a request for comment. The spokesman did repeat previous statements to the Las Cruces Sun-News about the purchase of the private plane. The governor’s office generally ignores requests for comment from NM Political Report.

The legislative leaders slammed Martinez’s administration, as they have for years on the issue.

“These accounts, written by longtime, local behavioral health care providers are disturbing,” Sanchez wrote. “New Mexicans—both the clients whose care have been jeopardized and the hundreds of professionals who lost their jobs—were harmed by the incidents outlined in these letters.”

“The Martinez Administration’s actions to shut down behavioral healthcare providers have had a negative impact on our economy, our safety, and our families,” Egolf said in a statement. “It is clear that the Human Services Department and the Governor’s cronies have stacked the decks against hard-working New Mexicans by courting out-of-state providers, all the while wasting $28.8 million in taxpayer money.”

Update: Added a response from the New Mexico Democratic congressional delegation.