No pattern of fraud found with 10 nonprofit providers

ALBUQUERQUE (AP) – The New Mexico Attorney General’s Office says there doesn’t appear to be any pattern of fraud by 10 nonprofits that provided behavioral health services to needy New Mexicans.

Attorney Hector Balderas announced the findings in a letter delivered Monday to state lawmakers.

Balderas said some regulatory violations were uncovered. Those are being forwarded to the Human Services Department for possible administrative action.

Balderas’ office is continuing to review two remaining providers. His office previously found no fraud but overpayment issues with three others.

The initial audit that raised allegations of fraud and abuse in 2013 alleged $36 million in state Medicaid funding was mishandled by the providers. That prompted Republican Gov. Susana Martinez’s administration to freeze Medicaid payments to the providers while the attorney general’s office launched an inquiry.

Human Services Department Spokesman Kyler Nerison released this statement on Monday:

“The undeniable facts are that a significant amount of public funding was misspent, and that shortchanged those in need in New Mexico. The Human Services Department will continue to work diligently to recoup the misspent and overbilled Medicaid dollars that were squandered by the agencies referenced in today’s decision by the AG.

To date, we have recovered over $4 million in misspent money, the agency that prompted the 2013 audits was indicted for fraud and six individuals throughout this process have been indicted for embezzling or misspending Medicaid money.

The decision to not prosecute clear over-billing and misusing Medicaid funds on things like private planes and luxury travel in the tropics belongs to the Attorney General. We respect but disagree with that decision and continue to believe that those funds should be used to help the people who need it the most.

In the last two years alone, we’ve increased behavioral health services by 84 percent as we work to ensure that those who are suffering from mental health and substance abuse issues get the help they need.”