Method of audit questionable
A SIMPLE QUESTION. Why are 15 N.M. mental health provider organizations “guilty?” The thousands of patients and the serving agencies still need a straight answer. It’s amazing – where is investigative journalism?
As a retired federal and city of Las Cruces staff person, I was around and/or involved in audits and their reviews, among other things, for over 30 years. Sure I’ve seen things that were done improperly. Haven’t we all? However, I had no occasion to see behavior like this one-sided approach to alleged audit findings. I say “alleged” because there is as of yet no provided evidence.
⋄ Paying an “auditor” on a commission basis for each problem found? How is this both neutral and sensible, especially when the same company working in North Carolina, among other places, has been proven to make charges that don’t hold up? Was this audit competitively bid out or legally sole source?
⋄ Using a process that shuts off services to thousands in N.M., but then engages out-of-state “providers” for the services. This is better than the normal process of just fixing audit findings except in extreme cases? And, why announce supposedly serious agency audit issues without providing the agencies the alleged facts? This is still true over a month later. Again, not normal practice. The state goes public and pulls funding where there are years of prior satisfactory federal and/or state audits? Who does this serve? And, on what basis were these out-of-state service providers chosen? Sole source? This is not good government.
The state is not serving the N.M. taxpayer. To me, the real issue is using inappropriate audit practices to slip in Republican flavored for-profit out-of-state providers for our well known and productive non-profit locals. Why?
“Government by organized money is just as dangerous as government by organized mob.” (FDR)
Why be fair, follow the law?
SECRET TRIBUNAL in New Mexico? Fifteen behavioral health providers have been accused, tried, convicted and sentenced by the Department of Health and Human Services. All of this took place in secret – with the approval of the attorney general – and without the accused being informed of their crimes.
Bravo, New Mexico! You have graduated from Third World status to join the ranks of the most oppressive governments in history.
ADELE E. ZIMMERMANN
It’s not about Obamacare
THE JOURNAL EDITORIAL “HSD funding cutoff traces to Obamacare,” August 1, is ludicrous and a pathetic fallback to the Journal’s favorite bogeyman: “Obamacare did it.” Does the Journal mean to say if it was not for Obamacare, we would still have a community-based mental health system serving the needs of the most vulnerable populations in New Mexico?
In her most recent performance at the Legislative Finance Committee, Secretary (Sidonie) Squier forcefully described all 15 agencies as committing not just some “credible” mistakes but egregious fraud. In her public statements she at least has had the grace to not blame Obamacare. She stressed repeatedly that the audit excluded simple errors and misjudgments and that only the most serious flaws were thrown in this hopper.
There are two issues being ignored by the Journal.
First, HSD concludes that companies who have served their communities for decades have been so fraudulent on her watch that only the nuclear option was possible: shut them down and bring Arizona to the rescue. No talk of rehabilitative or capacity development strategies. No wonder this is seen as a thinly veiled political agenda to privatize the not-for-profit mental health providers in the state.
Second, HSD admits that this fraud has been going on undetected for three years. The Journal and the governor appear quite content with this state of affairs. The secretary says she only knew about this in “bits and pieces” – words she used repeatedly at the Legislative Finance Committee hearing. Yet, some agencies, according to her, had 75 percent of their billing in error and no one knew! In fact, neither the public not the organizations still know what these problems are. It should be stressed that fraud should be rooted out, but it should also be noted that for-profit hospital corporations have been found guilty of millions of dollars in Medicare fraud. To think that bringing in for-profit management will somehow eliminate fraud is simplistic and foolish. What is needed is intelligent oversight, and regular monitoring.
In this context, these Arizona organizations Secretary Squier has so much faith in to clean up New Mexico – was Public Consulting Group asked to audit them first? Are those results available? Or did she examine their “bits and pieces” and give them a pass?
And finally, who is next to be judged, according to these lofty standards? Would HSD apply PCG audits to our state’s four managed care organizations who manage Medicaid’s health care delivery systems – or does she realize that she tangles with those organizations at her own peril?