Politicians, activists, providers and patients protesting the temporary suspension by the Human Services Department of Medicaid payments to 15 nonprofits that deliver behavioral health services around New Mexico are targeting the wrong people.
The requirement to suspend payments where fraud is suspected is part of President Obama’s Affordable Care Act. Remember, a portion of Obamacare costs was to be paid for by reducing waste and fraud.
On March 9, 2010, Obama unveiled his plan to crack down on waste and fraud in Medicare, Medicaid and other government programs by expanding the use of payment recapture audits, which are structured to give private auditors financial incentives to uncover improper payments. At the time, Obama predicted the use of such audits could return up to $2 billion in taxpayer money to federal coffers over three years.
In line with this intensified attempt to recover misspent federal funding, the basis for withholding payments as outlined in Title 42 of the Code of Federal Regulations was changed in 2011.