Third behavioral health provider to leave New Mexico - Albuquerque Journal

Third behavioral health provider to leave New Mexico

Copyright © 2016 Albuquerque Journal

SANTA FE – An Arizona behavioral health company brought in to replace New Mexico providers after a 2013 shake-up said Friday that it will cease operations and no longer provide services after June 30.

Agave Health Inc., which runs mental health and addiction treatment programs in Bernalillo, Santa Fe and about 10 other counties, serves more than 3,000 children and adults.

The company cited ongoing financial hardship and Medicaid rate reductions as reasons for its decision.

“We deeply regret this drastic measure and realize the impact this will have on staff, consumers and community partners,” Agave executives said in a statement.

The move means that, as of July, three of the five Arizona providers brought in by Gov. Susana Martinez’s administration in 2013 to replace New Mexico nonprofits accused of overbilling and fraud will have pulled up stakes in the state.

La Frontera phased out its services in southern New Mexico last year; Turquoise Health and Wellness had ceased operating in the southeastern part of the state before that.

Agave had previously moved to cut employee salaries and mileage rates due to operating losses, but company CEO Heath Kilgore insisted in a 2014 interview that the company was “here to stay.”

In its Friday announcement, Agave pledged to work with the managed care organizations that run New Mexico’s Medicaid program to ensure there’s a smooth transition for the company’s clients.

A Human Services Department spokesman said the agency is also working to ensure there are no coverage gaps.

“All cases will be evaluated and assessed and the most at-risk cases will take precedence,” HSD spokesman Kyler Nerison said Friday. “Our top priority in any transition is maintaining uninterrupted care for those who need it and protecting access to behavioral health services for consumers.”

He said the agency has a bilingual hotline to assist patients who need immediate help.

However, Senate Democrats expressed concern about the situation, saying Agave’s decision to leave the state could lead to job losses and an interruption of services for clients with serious mental health and substance abuse problems.

“These services are not a luxury and are not easily replaceable,” said state Senate Democratic Floor Leader Michael Sanchez of Belen. “We are witnessing a slow-motion train wreck for many New Mexicans.”

In June 2013, the Human Services Department cut off Medicaid funding to the 15 behavioral health nonprofits operating in the state, saying an outside audit showed more than $36 million in overbilling, as well as mismanagement and possible fraud. The agency brought in the five Arizona providers to take over.

However, 13 of the 15 nonprofits that were shut down – many are now out of business – have been exonerated of fraud. Attorney General Hector Balderas cleared 10 of the nonprofits earlier this year; the AG’s Office is still investigating two others.

More than 160,000 New Mexicans received behavioral health services in 2014, with most of those services funded by Medicaid, according to the Human Services Department.

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