ALBUQUERQUE, N.M. — Claim says action came after alleged Medicaid violations reported
A lawyer says she was fired by the Human Services Department because of her whistle-blowing on Medicaid-related matters – including the recent behavioral health audits – while the agency says her claims are baseless.
Elizabeth Jeffreys sued the department in state District Court last month, complaining that she was fired in June after she reported alleged violations of law and malfeasance in the Medicaid program to the attorney general and state auditor.
Jeffreys alleges that she was discriminated and retaliated against and that her work environment was hostile.
The HSD counters with this from spokesman Matt Kennicott: “Jeffreys’ claims are completely without merit and are retaliation for her being passed over for promotion.”
According to the lawsuit filed in 1st Judicial District Court in Santa Fe, Jeffreys had worked for the HSD’s Office of General Counsel for 10 years, advising staff and representing the agency in litigation, including Medicaid provider cases. She says regular evaluations consistently rated her performance as good to excellent.
She says she was repeatedly passed over for promotions in the Office of General Counsel in 2011 and 2012 in favor of male attorneys. After she complained to the Human Rights Bureau about gender discrimination, she was “isolated and marginalized” within the office, the lawsuit contends.
Jeffreys says in the lawsuit that she went to the state auditor and the attorney general in February of this year complaining of irregularities related to behavioral health audit arrangements. Included in her allegations: that the state’s behavioral health overseer, OptumHealth , did not conduct required audits, and that the HSD should have sought reimbursement from OptumHealth for audits not done.
The HSD disputes her claims, saying it was OptumHealth audits that first raised red flags about 15 behavioral health providers currently under investigation by the attorney general’s office.
Jeffreys also complained that HSD’s contract with Boston-based Public Consulting Group to audit the 15 nonprofits did not go through the proper channels, in violation of the state procurement process. The HSD disputes that, as well.
Jeffreys also sued HSD in 2011 in state District Court over the denied promotions, saying the agency wasn’t following its own selection process; that case is still pending. The recently filed lawsuit over her firing alleges gender discrimination as well as whistle-blower violations.