Hasty public allegations of fraud can damage a program’s reputation in the community. Recall that similar allegations of “Medicaid fraud” from Gov. Susana Martinez’s administration destroyed several long-standing behavioral health providers in the community. …
There are … omissions and misrepresentations in the Jan. 13 editorial, “ABQ’s taxpayers need accountability for homeless dollars.” It was only after publication of an op-ed piece criticizing the city’s strategy for combatting homelessness the city used the word “fraud,” informed HopeWorks we were under investigation and had top city officials personally calling board members. HopeWorks currently holds about $4 million in city contracts, not $9.6 million. The city’s deadline for repayment of the alleged debt is Jan. 22, yet the editorial implied we were nonresponsive and out of compliance. Behind the scenes, HopeWorks has already reached out to the city to discuss how to move forward. We are committed to resolving this misunderstanding quickly so we can return our focus to the vital work of providing services to those experiencing homelessness.
HopeWorks, formerly St. Martin’s, has been billing Medicaid for over 20 years with no allegations of double billing. We have held city contracts for decades with no issues and passed city internal audits of our programs. HopeWorks has comprehensive checks and balances, maintains strict processes and procedures for Medicaid billing and is fully compliant with all federal regulations. We hold ourselves to high accountability and ethical standards.
HopeWorks strongly disputes the city’s Office of the Inspector General (OIG) finding we owe the city $155,586.25, based on a misunderstanding of the difference between the distinct revenue streams of Medicaid and grant billing. As a Certified Mental Health Center, HopeWorks can bill for Medicaid services, and we use very specific accounting codes that match the types of service rendered. When we bill city grants, including the Assisted Outpatient Treatment (AOT) contract in question, we are not billing for services rendered but for program staff, cellphones and mileage, necessary supplies and other program costs. We believe the explicit terms of the contract and the city’s monitoring and implementation practices do not support the OIG’s report. Finally, the $15,653.58 allegedly not backed up in our general ledger were services billed to Medicaid after HopeWorks and the city agreed to end the AOT contract on June 1, after which no general ledger for the city AOT contract was needed, although we have continued to serve clients and bill Medicaid for services rendered.
The OIG’s report, publicly available (at cabq.gov), contains vague recommendations and methodologies. The OIG released the final report at 5:09 p.m. on the same day it asked at 9:45 a.m. for AOT program documentation, allowing us insufficient time to produce the necessary documents.
The good work HopeWorks has been doing for over 35 years in the community is needed now more than ever. The allegations do not deter our compassion and commitment in serving those experiencing homelessness.
Editor’s note: The city maintains HopeWorks has $9.6 million in city contracts. HopeWorks did not return multiple phone calls from the Journal before the Jan. 8 story about the city’s audit or the Jan. 13 editorial.