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Judge rules behavioral health provider entitled to hearing on 2012 Medicaid funding suspension

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A state district judge in Santa Fe ruled today that a provider of behavioral health services is entitled to a hearing on why his Medicaid funding was suspended in early 2012.

State District Judge Raymond Ortiz ruled in the case of Dr. Babak Mirin, a psychiatrist. Ortiz said due process requires that Mirin be granted a hearing by the Human Services Department, especially since the payments have been held up for a year and a half.

An HSD lawyer said the department likely would appeal the ruling and try to block the hearing.

The department suspended the payments to New Mexico Psychiatric Services in February 2012, saying there was a credible allegation of fraud against the Roswell provider, but giving him no details. An investigation by the attorney general’s Medicaid fraud unit is still ongoing.

Psychiatric Services eventually got its Medicaid funding restored by HSD, but Mirin’s lawyer told the judge that up to $600,000 is still owed for services provided by Mirin and his network of  behavioral health professionals.

Ortiz’s ruling has no immediate bearing on the 15 behavioral health nonprofits that have been in the news recently. Their funding was frozen in late June because HSD determined there were credible allegations of fraud against them, and a dozen of them are being replaced by Arizona providers. Some of them have a case pending in federal court, in which they argue they are entitled to hearings to clear their names.

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