State audit shows New Mexico behavioral health facilities overbilled federal and state government by tens of millions of dollars
June 25, 2013
ALBUQUERQUE, N.M. (AP) - Fifteen New Mexico providers of mental health and substance abuse services failed to meet standards, overbilled the federal and state government by tens of millions of dollars, and may have taken part in fraudulent activities, according to a new state audit released Monday.
New Mexico Human Services Department officials said the audit found that "errors and overpayments were so widespread that the business and billing practices of every provider (in the audit) warrants careful scrutiny."
It also found "mismanagement, fraud, waste and abuse" in the treatment of potential suicide victims, including disregard for follow-up care and basic policies.
Department Secretary Sidonie Squier said that, as a result of the audit, Medicaid payments would stop immediately to all 15 providers and out-of-state managers would be brought to New Mexico to manage behavioral health care services for patients.
In addition, she said the results of the five-month audit have been forwarded to the New Mexico Attorney General's Office for further investigation of potential fraud.
"New Mexico can't risk this type of activity," Squier said in an interview with The Associated Press.
The audit did not list the names of the providers targeted. But state officials said they accounted for more than 85 percent of the state's behavioral health spending for more than 30,000 patients.
Providers contacted by the AP did not immediately return phone messages.
New Mexico has some of the highest suicide and drug overdose rates in the country, with 19.9 suicides per 100,000 people. The national suicide rate is 12.4 deaths per 100,000, according to the Centers for Disease Control and Prevention
The audit also found that providers overbilled taxpayers by $36 million and that the companies had error billing rates that far exceeded the national average.
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