By Tom McDonald
If there’s an issue out there that could slow Gov. Susana Martinez’s cakewalk into a second term, it might just be the behavioral health issue.
The issue surfaced a year ago when, after an audit alleged Medicaid overbilling and possible fraud to the tune of about $34 million, the Martinez administration froze out 15 New Mexico companies providing services to people with mental illnesses and disabilities. She brought in five Arizona firms to act as the providers instead.
Apparently we were supposed to take all this at face value. The media — and, by extension, the public — have not been able to see the details, since the audit has not been deemed a public document. Newspapers and other open government groups have sued for access to no avail.
Moreover, the 15 New Mexico providers that were notified by HSD of “credible allegations of fraud” were never given a chance to examine the details and defend themselves. Consequently, we really don’t know if the state was justified in its actions against them.
All we have so far are some limited findings from Attorney General Gary King’s office, which so far has found no evidence of fraud by two of the 15 companies (investigations on the others are pending), while State Auditor Hector Balderas found more problems with the audit itself than with the providers.
Of course, King is running for governor against Martinez and Balderas for AG, and both are Democrats, so it’s reasonable to question their credibility on this issue.
Better to turn to newspapers for some straightforward reporting, and in my opinion the best reporting has been by Patrick Malone, a reporter for the New Mexican in Santa Fe.
Malone has shed light on the switch to the Arizona providers by determining that New Mexico was paying at least one of them before the audit was even started. He found that the state paid Agave Health Inc. $172,447 — before the audit was completed.
Not only that, but it turns out the price tag to move the services from the New Mexico providers to the Arizona firms is pretty hefty by itself — about $24 million and counting.
It begs the question, is Martinez in cahoots with these Arizona companies politically? So far, the political connections found have only been indirect, but circumstances do suggest a conspiracy of sorts.
As for her opponent, King is in a precarious position. As the state’s AG, he’s charged with investigating the audit allegations for possible criminal misconduct, and he needs to be apolitical in doing that. That may explain why he hasn’t been more vocal about the issue.
Or, perhaps he knows there are indeed some “credible allegations” within the audit’s findings.
But that’s speculation, so let’s look instead at what we know: Even before the audit was done, the Martinez administration was pulling in outside help that would eventually take over behavioral health services; and as it turns out, that outside help charged dearly for its services.
And here’s what we don’t know: One year into the “credible allegations of fraud” claim, we still don’t know if it’s true, false or exaggerated.
Both Martinez and King know what the audit says, but neither of them is releasing any more than they have to.
All this bodes better for King than it does for Martinez, since the AG looks appropriately restrained and Martinez appears unreasonably obstinate.
Tom McDonald is editor of the New Mexico Community News Exchange. Contact him at: