Childcare Assistance Program

Childcare workers with COVID-19 can get state-funded insurance

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The state announced that uninsured childcare workers who test positive for COVID-19 will be able to enroll in a state insurance plan during the public health emergency. Uninsured early childcare workers and their families will be able to enroll in New Mexico Medical Insurance Pool (NMMIP), the state’s high-risk pool, during the public health emergency if they or their family members test positive to COVID-19, a type of coronavirus. The state will pay the premiums, according to the statement. Under emergency rules issued by the Superintendent of Insurance, deductibles and copayments are also waived for treatment of COVID-19, influenza and pneumonia through NMMIP. This new rule will apply to all childcare workers and their immediate family members who test positive regardless of income or immigration status, Gov. Michelle Lujan Grisham said in the statement.

Quick Reads

Legislative roundup, Feb. 12, 2019

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Days remaining in session: 33

Prison profits: Gov. Michelle Lujan Grisham’s inaugural committee says it will give a donation from the private prison company Geo Group to charity. The Florida-based firm runs several prisons in New Mexico and has contributed to politicians on both sides of the aisle. According to financial disclosures Lujan Grisham’s inaugural committee published last week, Geo Group donated $2,500 to the Democratic governor’s inaugural festivities. Democratic politicians have faced awkward questions about financial contributions from the private prison industry amid outrage over the federal government’s zero-tolerance policy toward undocumented migrants. Companies like Geo Group have stood to gain from the federal policy.

2018 Legislative Session

Some Martinez vetoes get pushback

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Some vetoes by Gov. Susana Martinez are raising eyebrows among legislators and others—and at least one partial veto may be challenged in court. Wednesday was the final day for Martinez to decide whether or not to sign bills from this year’s legislative session. She signed 80 bills into law, but vetoed 31 others. Some she rejected using her veto pen, while with others she just allowed time to run out in what is called a “pocket veto.”

One portion of a bill that may see a new life was part of the crime omnibus bill the Legislature passed in response to the spike in crime, particularly in Albuquerque. The bill combined a number of ideas aimed at reducing crimes.

Behavioral Health

With agreement in hand, behavioral health CEO believed vindication was inevitable

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Even in his final days of battling leukemia in early 2016, Jose Frietze was fighting for the youth services agency he founded in 1977. The state Human Services Department had accused the organization — Las Cruces-based Families and Youth Inc. — of potential Medicaid fraud and overbilling by $856,745 in 2013. A stop payment of $1.5 million in Medicaid funding for services already provided crimped FYI’s cash flow, leading to layoffs. And because of the accusations, FYI was forced to hand off part of its business to an Arizona company brought in by Gov. Susana Martinez’s administration. Frietze’s daughters Victoria and Marisa remember how tough the allegations were on Frietze and their family.

Behavioral Health

The slow-motion unraveling of New Mexico’s Medicaid crackdown

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There’s no getting around it. Four years after Gov. Susana Martinez’s administration charged 15 behavioral health organizations with potentially defrauding the state’s Medicaid program, its case has experienced a slow-motion unraveling. No Medicaid fraud was ever found. And those eye-popping estimates that added up to $36 million the organizations had overbilled Medicaid? In the summer of 2017, the Human Services Department (HSD) is seeking drastically lower reimbursements for overbilling the public health insurance program for low-income residents, a review of public records and state court documents has found.

Brent Earnest

Special master: HSD staff shakeup needed to address SNAP problems

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LAS CRUCES—A year-old scandal involving alleged systemic fraud with the state’s management of federal food aid benefits was the elephant in the federal courtroom Thursday. Both Kenneth Gonzales, a federal district judge, and Lawrence Parker, a court-appointed “special master” who is tasked with guiding the New Mexico Human Service Department (HSD) in its federal compliance with Medicaid and Supplemental Nutrition Assistance Program benefits, alluded to the scandal at the hearing. “What nobody wants to see, and you especially, is a culture that allows this to happen,” Gonzales told HSD Secretary Brent Earnest. Parker emphasized that “many of those same people” who were alleged in 2016 to have instructed HSD employees to falsify SNAP applications to meet federal quotas “are still in place” at the department.[perfectpullquote align=”right” cite=”” link=”” color=”” class=”” size=””]No ads. No clickbait.

Easter Seals El Mirador

NM settles $2.8M Medicaid overpayment claim for $485

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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.

backlog

Medicaid renewal delays balloon as HSD gets control of SNAP backlog

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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.

Human Services Department

State blames five-month bungling of Medicaid case on ‘computer glitch’

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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.

Health

ACA repeal would have big impact on recovering addicts

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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.