Monday, August 5, 2013

Committee Wants Sebelius to Intervene in Behavioral Health Controversy

A legislative committee has sent a letter to US secretary of Health & Human Services Kathleen Sebelius asking her to intervene to resolve the controversy over the behavioral health providers whose Medicaid funds were frozen during fraud investigation.

"We fear that within days or weeks, New Mexico's existing and already fragile statewide behavioral health system will be the casualty of the misapplication by the (Human Services Department) of these new ... Medicaid fraud and abuse laws and regulations," the 9-page letter from the interim Health & Human Services Committee says.

The regulations, according to the letter gives "the state executive Medicaid agency broad discretionary powers to impose sanctions that may put a provider out of business before any adjudication of wrongdoing and it gives that same agency a powerful tool to intimidate those who provide service to Medicaid recipients and stifle any constructive criticism from this same group."

The letter lists the current financial status — which ones have run out of funds, which are furloughing employees, etc. —  of most of the 14 de-funded providers.

The letter says that the committee believes Sebelius' department and the Center for Medicare & Medicaid Services are "the only parties capable of resolving this crisis in a timely manner and in a way that preserves access and services for thousands of New Mexico's most vulnerable people while fraud investigations are under way. We urge you to take swift action to bring this crisis to an end."

The letter is signed by Committee Chairman Rep. James Roger Madalena, D-Jemez Pueblo and Vice Chairman Jerry Ortiz y Pino, D-Albuquerque. Copies were sent to all members of the the state's Congressional delegation and other federal officials.

Below is the letter, plus about 120 pages of other documents related to the controversy. More in tomorrow's New Mexican.