Martinez rejected fair protection for providers - Albuquerque Journal

Martinez rejected fair protection for providers

One of the great disappointments that remains since the 2017 legislative session ended is Gov. Susana Martinez’s veto of bipartisan legislation to protect Medicaid health providers who stand falsely accused of fraud by the state. Known as the Medicaid due process bill, Senate Bill 217 was killed with a pocket veto by the governor. That’s a fancy way of saying she never needed to offer an explanation why she chose to veto it – and she didn’t. The results may be with us long after the session is forgotten.

Medicaid due process was common-sense legislation. It simply would have guaranteed that in the future, any health care provider to Medicaid patients who stands accused of wrongdoing would receive the opportunity to review the allegations made against them and the chance to respond in an administrative hearing or in district court.

Recent history proves that New Mexico needs those protections: They did not exist in 2013 when 15 nonprofits and other behavioral health firms were accused and mostly put out of business by the governor’s administration. All were later cleared of any wrongdoing by the attorney general, however.

Four years later we still witness the tragic consequences affecting countless at-risk children and adults in serious need of mental health treatment but who are not receiving care. In many communities, these crucial health services for residents are withering away. Nearly all of the Arizona behavioral providers the governor brought to New Mexico in the aftermath now have left. It is a terrible situation, and her veto has compounded it.

As citizens, we all have the right to due process if we are accused of wrongdoing. My legislation sought to ensure transparency and independent analysis in those situations when it is needed. What has happened to behavioral health in New Mexico must never occur again – not in behavioral health nor other areas of health care.

More than 30 percent of our residents today are eligible for Medicaid. Yet many health care professionals – primary care, general practitioners, nursing homes, dentists and behavioral health – are reluctant to provide or expand services based on the state’s behavioral health experience in the absence of ordinary due process protections. It raises the important question of whether residents will have access to health care. And there already are large gaps in access and coverage across our state. Many providers are understandably afraid to speak out about the situation for fear of being punished in some way by the state.

Also, even though the accused behavioral health providers were cleared by the attorney general, the governor’s administration has never returned millions of dollars owed to them for services they performed. It is not something one would expect in the United States of America.

How many people with mental health disorders are going without treatment for their conditions today because of the disruption of services caused by the 2013 takeover? We don’t really know, but you can bet it’s a lot. Many of them are turning up in our jails. That is morally wrong.

Five years into the state’s mental health care crisis, there is no interest from the Governor’s Office to resolve it. All we got was a pocket veto and no explanation for it.

New Mexicans still deserve to know why the state’s entire network of treatment for individuals struggling with mental illness was upended without any reasonable basis. We also need to know why the governor vetoed due process protections that would have ensured it could not happen in the future. Most importantly, we still face the challenge of getting the state’s behavioral health system back on its feet, delivering treatment to vulnerable children and adults.

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