August 21, 2019

HSD settles with two more behavioral health providers

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The state of New Mexico announced two more settlements in lawsuits filed by behavioral health providers who had their Medicaid funds frozen by the state in 2013. 

The state Human Services Department settled with TeamBuilders Counseling Services, Inc. and Counseling Associates, Inc. Last month, the state settled with three other providers.

“These settlements reflect a shared commitment to rebuild what was lost,” HSD Secretary David R. Scrase, M.D. said. “We are continuing to work with other behavioral health provider litigants affected by the 2013 New Mexico Medicaid payment freeze and to reconstruct this essential network of services that so many vulnerable New Mexicans need and rely on.”

“We are grateful for the swift action and efforts of Governor Michelle Lujan Grisham and HSD Secretary David Scrase to resolve this matter,” TeamBuilders CEO Shannon Freedle said. “We appreciate finally being able to put this to rest and are hopeful for the future of New Mexico’s behavioral health system and the people who depend on those services.”

The settlements do not include any admission of liability or fault on either side. Counseling Associates paid $11,854.16 under the agreement, while the state paid $173,573.84 to Counseling Associates’ attorneys. The state paid nearly $1 million to TeamBuilders, while TeamBuilders paid the Human Services Department $107,587.23.

The state said they found credible allegations of fraud among 15 behavioral health providers and froze funding for their services. The lack of funding caused several providers to go out of business. And by 2016, the state Attorney General had cleared all of the providers of the allegations of fraud.

“As State Auditor and Attorney General, I investigated the behavioral health crisis caused by the previous administration and worked to ensure the process was transparent to the public,” Balderas told NM Political Report in a statement. “I am hopeful that these settlements mean that we are on our way to rebuilding much needed behavioral health services for New Mexican families.”

The lawsuits stem from 2013, when the state alleged that providers overbilled the state of millions of dollars in Medicaid funding for behavioral health services, using extrapolations from Public Consulting Group Inc., a Massachusetts-based company. However, when fully investigated, the claims were just a tiny fraction of the amount originally claimed by the state.

The resulting transition led to a disruption of behavioral health services for thousands of New Mexicans during a slow-motion unraveling of the state’s behavioral health systems.