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Most of Medicaid audit to stay secret

ALBUQUERQUE, N.M. — A state district judge ruled Wednesday that most of the 2013 state Human Services Department audit involving alleged Medicaid fraud by 15 nonprofit groups will remain under wraps despite calls for the report to be made a public.

District Judge Jennifer Attrep largely set aside a legal request by the New Mexico Foundation for Open Government to force the New Mexico Attorney General’s Office to release the 18-month-old audit document.

The only part of the audit to be released after the Foundation for Open Government’s lawsuit will be a section related to Presbyterian Medical Services.

“We obviously have mixed feelings,” FOG Executive Director Susan Boe said of the court’s ruling. “We’re glad that the public will be able to see a small portion of the audit, but we continue to believe that this is a public document that the public deserves to see.”

FOG is evaluating whether it will appeal the District Court decision to the New Mexico Court of Appeals, Boe said.

Portions of the 355-page audit document had previously been released, but the majority of the document – about 264 pages – remained secret. The section ordered by the District Court to be released accounts for 23 pages of the previously withheld material.

As of Thursday, Boe said, those pages had not yet been turned over to FOG by the Attorney General’s Office. Attorney general’s spokesman Phil Sisneros did not return calls for comment Thursday.

The Presbyterian information was ordered by the court to be made public because HSD had previously released the pages to Presbyterian officials for review. That disclosure, the court said, waived the state’s claim that the document is exempt from the New Mexico Inspection of Public Records Act.

The HSD audit is in the hands of the Attorney General’s Office after HSD referred the allegations of fraud to the state’s top law enforcement official for a criminal investigation. Attorney General Gary King has defended the secrecy of the audit, saying it was evidence related to an open investigation. AG’s office staff have said that investigation could take up to six years to complete.

King’s term as AG ends this month. King will be replaced by Hector Balderas, who was elected in November.

The 2013 audit alleged $36 million in state Medicaid funding was mishandled by the 15 nonprofit behavioral health services providers. After the audit, HSD halted Medicaid funding to the nonprofits and eventually replaced several with companies from Arizona. Many providers protested that their funding was cut without notice of the allegations against them.

Two of the 15 providers have been cleared by the Attorney General’s Office, but HSD has asked the AG to reconsider criminal charges against one of the exonerated agencies.