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Probe of Medicaid services could take months

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By Associated Press

ALBUQUERQUE (AP) — State Attorney General Gary King said Wednesday it could take several months for his office to complete an investigation of overpayments and possible fraud by behavioral health providers in New Mexico’s Medicaid program.
King told the Legislative Finance Committee his office hasn’t made a determination about the allegations forwarded to his office by the Human Services Department. There are 17 investigators assigned to the case.
The department froze payments last month to 15 nonprofits that provide mental health and substance abuse services after an audit found what the agency said was a high rate of billing problems and possible mismanagement.
King said his investigation of the allegations would determine whether there’s evidence of fraud justifying criminal prosecutions or possible civil actions against the behavioral health providers.
“I think it would be an abrogation of my responsibility not to investigate those,” King said.
Human Services Secretary Sidonie Squier defended her agency’s action in testimony to the committee and assured lawmakers that steps were being taken to prevent an interruption of services to patients. Contracts have been signed with five providers from Arizona to step in and provide assistance.
Squier said the department has restored full or partial funding to three of the New Mexico behavioral health providers after they asked for exceptions to the Medicaid payment freeze. Similar requests from other providers were denied.
Senate President Mary Kay Papen, D-Las Cruces, said she worried the department’s freeze would cause nonprofit providers to go out of business.