Two Behavioral Health Providers Get Funding Restored

UPDATED 

Human Services Secretary Sidonie Squier

(See below the Human Services release)

 In the latest development in the behavioral health shakeup, the state has agreed to restore Medicaid funding to two New Mexico providers under investigation. 

Here's the press release from the state. . 

Santa Fe – Today, the New Mexico Human Services Department (HSD) announced the release of two additional Medicaid pay-holds to agencies audited by the State earlier this year.  Both agencies are severing ties with TeamBuilders and its various corporate and non-profit affiliates and will together agree to repay $4,240,000 in behavioral health funding alleged to have been improperly billed to the Medicaid system.  

Presbyterian Medical Services (PMS) and Youth Development, Inc. (YDI) received the lift on their pay-holds after agreeing to pay back overpayment amounts found by a recent audit of behavioral health companies in New Mexico.  PMS will repay $4,000,000 and YDI will repay $240,000.  PMS and YDI will also be subject to intensive new training and oversight of its management until billing and management systems are fully operational and determined to be sound.  

Each of the companies will continue to provide behavioral health services to their clients, though Valle del Sol will provide temporary oversight of YDI and La Frontera will provide temporary oversight of PMS.  Among other tasks, Valle del Sol and La Frontera will train and provide technical assistance to staff members at each company, ensure program compliance with state and federal laws and rules, require accurate and timely billing (including pre-submission review of claims), and assist in developing new performance measures.    

“We have a responsibility to protect taxpayer dollars and to ensure that consumers are receiving continued access to care. This is a positive outcome that allows us to recoup a significant portion of the Medicaid funding that has been identified as overpayments,” said HSD Secretary Sidonie Squier. “PMS and YDI should be commended for working with the State from the get-go to improve service delivery, acknowledge the need to repay overpayments assigned to their work, and sever ties with other troubled entities.” 

PMS and YDI are not among the behavioral health companies with the most serious or numerous whistleblower complaints against them, which include allegations that, in other companies, employees were told to intentionally up-code services as a means of siphoning extra money out of the Medicaid system, told to bill for services never provided, or told to obstruct the reporting of critical incidents to proper authorities and regulators. 

Additionally, neither PMS nor YDI are as deeply engrained in the complex financial relationships and potential conflicts of interest that exist around the entities that comprise the seven Rio Grande behavioral health care companies and the numerous not-for profit and for-profit companies that are closely related to TeamBuilders.  

Today’s announcement is separate and distinct from, and has no bearing on, the continuing criminal investigation being conducted by state and federal authorities into the conduct of all 15 companies audited this year.

UPDATE 3:35 p.m. Some new information since I first posted this.

Human Services spokesman Matt Kennicott said that there are no other settlement negotiations with any of the other providers under investigation.

Unlike other providers under investigation, both PMS, which operates statewide, and YDI, which has facilities in Albuquerque and in Valencia County, have remained open seeing their clients for the past several months. Kennicott said they have been using their cash reserves to stay afloat.

PMS serves 3,400 behavioral health clients on Medicaid, while YDI serves about 260.

Sen. Bill O'Neill, D-Albquerque, who has been one of the leading critics of the administration over the mental-health shakeup, had the following statement about today's developments:

"To me, this is just more of the same attempt at positive spin by the Martinez Administration. Whatever the ultimate resolution of this (Human Services Department) induced audit crisis is, there was absolutely no reason to destroy our existing state's mental health system in the process. The 15 non profit behavioral health providers were not given the chance to review the findings and respond accordingly. They were denied due process. We still do not know what the actual allegations are -- none of us do. I have also noticed that (Human Services) is very fond of the word `siphon.' Well, how about the word, `hijacked'? Or `hostile takeover', by out-of-state, Arizona companies?"

Youth Development Inc. just sent this news release:

After four months of working with the Human Services Department on the behavioral health audit conducted by PCG, YDI and the Department have reached a settlement.    However, YDI did not fully agree with the processes employed by the State and PCG.  Seeking resolution, YDI fully cooperated with HSD in this matter and continued to provide services while payments to it were suspended. 

In the interest of resolving all differences between YDI and HSD amicably, and in order to avoid the time, trouble, expense, delay and uncertainty of the time litigating this matter we believed this was the most prudent path for YDI to take. 

The amount settled for is about 8 percent of the amount billed over the last 3 years.  According to the GAO, the National average claim failure rate is between 3 percent  and 9 percent .  We are working diligently with the State and Valle del Sol to improve to our behavioral health systems in order to reduce that rate to zero.   

We look forward to continue to serve the many people who are our consumers and who have put their faith and confidence in the critical services YDI has provided for over 42 years.

UPDATE: 5:15 pm  PMS just issued a statement quoting CEO Steve Hansen saying, "While we have never agreed with the State’s contentions, allegations, or actions, PMS’s primary motivation in settling was to preserve its critical safety net behavioral health services and over 200 New Mexico behavioral health jobs.”

The statement also said, "This settlement resolves all potential civil and administrative disputes with the State. PMS was unwilling to sacrifice services to so many New Mexico communities, choosing resolution instead of a long legal battle."

More in tomorrow's New Mexican.

Susana Martinez: Jersey Girl

So where in the world is New Mexico Gov. Susana Martinez today?

New Jersey, of course. After her recent swing through the South, Martinez is in Jersey campaigning for Gov. Chris Christie, who is up for re-election tomorrow. Republican Christie is expected to win big and start immediately campaigning for president.

Martinez will join him at campaign stops in Nutley, Hillside, Freehold, South Plainfield, Morris Plains, and Union City, according to NJ.com.

In 2010, Christie campaigned for Martinez here in New Mexico.

The report from NJ.com says Martinez's appearances is Christie's

... latest attempt to reach out to the Hispanic community, a constituency he has courted often throughout his campaign and one Christie will need should he jump into the 2016 presidential election.

"As we enter the final days of the campaign having her on the trail is going to help us tell our story and bolster our vision for the next four years," said Christie campaign spokesman Kevin Roberts. It also makes another statement about what we are doing and the non-traditional support we are getting."

New Jersey Democrats aren't happy about this. In a news release the state party wrote, "... Christie and Martinez have a lot in common. Both governors are former prosecutors with records of abusing their official powers to reward their political allies and tank their state economies."

ROUNDHOUSE ROUNDUP: More Fun With Common Cause's Lobbyist Report

What industry had the most lobbyists working the New Mexico state Legislature this year? Was it the oil and gas industry, which is responsible for a huge portion of state revenues? Was it the big pharmaceutical companies? The liquor industry? Ranchers? Chile farmers?

None of the above, actually. According to the study released last week by Common Cause New Mexico, the special interest that hired the largest number of lobbyists was government, including local and tribal governments as well as public educational agencies.

The study found (based on information from the Secretary of State’s website and the Institute of Money in State Government) that there were 250 lobbyists hired by government agencies working the Roundhouse halls during the last session, which ended in March.

Look at it this way: There are 112 legislators, so there were more than two government lobbyists for every lawmaker.

For more check out today's New Mexican.

For my story on the lobbyist report last week CLICK HERE

For the Common Cause report itself CLICK HERE

Governor Chooses Vickie Perea for Easley's Seat

If you predicted that Gov. Susana Martinez would chose a fellow Republican to replace the late Stephen Easley in the state House of Representatives, you were right.

Martinez went with Vickie Perea, a former Albuquerque city councilor. This means the political composition of the House will be 37 Democrats and 33 Republicans in next year's session. Perea will have to run for election to the seat next year if she wants to stay.

Here's the governor's statement:

Today, Governor Susana Martinez appointed Republican Vickie Perea to the State House of Representatives District 50 seat. Perea will fill the vacancy created by the passing of State Representative Stephen Easley. She will assume the term that ends December 31, 2014. 

Perea, a former Democrat, is a  native New Mexican, wife, mother, and grandmother with a varied, life-long history of public service. As an employee and administrator at the City of Albuquerque, she served for twenty-five years. After her retirement from the City, Perea served for four years as a City Councilor, which included service as Council President. In addition to her tenure as an elected official, Perea has devoted much of her time to service in other capacities, including past work as a Regent for Trinity International University, as a member of the Board of Directors and Chairperson of New Mexico First, and as Vice-Chairperson of the Unification Charter Commission for the City of Albuquerque/Bernalillo County.  She has previously also been involved with the New Mexico Municipal League and the Hispano Chamber of Commerce. Perea attended the University of New Mexico and completed the program for executives in state and local government at the John F. Kennedy School of Government at Harvard University and holds an Honorary LLD, Doctor of Laws from Cohen University and Theological Seminary.  

“I had an opportunity to speak with all three nominees for this position and appreciate their willingness to serve,” Governor Martinez said. “In Vickie, the citizens of House District 50 have a passionate public servant who will bring a fresh voice to the Legislature.  She is capable of working across party lines and is well-qualified to help craft public policy that will benefit New Mexico’s economy, schools, and families.” 

More in tomorrow's New Mexican

SF County Commission Nominates Jenkins for Easley's House Seat

Ann Jenkins

The Santa Fe County Commission on Tuesday nominated Ann Jenkins, a retired information manager who worked for a pharmaceutical company for 27 years, to complete the term of the late Rep. Stephen Easley in the state House of Representatives.

Jenkins, also has been nominated for the position by the Bernalillo County Commission. Two other counties in the sprawling District 50 have nominated other candidates. Valencia County nominated former Albuquerque City Councilor Vickie Perea while the Torrance County Commission chose its own chairman, LeRoy Candelaria.

Both Perea and Candelaria are Republicans, as is Gov. Susana Martinez, who will make the final selection. If she picks a Republican to replace Democrat Easley, the political makeup of the House would be 37 Democrats to 33 Republicans.

A spokesman for Martinez said the governor is expected to make a decision by Friday.

Jenkins in an interview Tuesday described herself as a centrist Democrat. "I'm fairly conservative on financial issues but liberal on social issues," she said.

Her husband of 43 years, Jim Jenkins, is a Republican, she said.

More in tomorrow's New Mexican

Another Potshot From Linda to Gary

As my colleague Robert Nott reported in today's New Mexican, it looks like Public Education Secretary Hanna Skandera finally will get a confirmation hearing in the Legislature.

AG King

If you're skeptical, you have every right to be. After all, Skandera actually did get a hearing last year -- one that lasted umpteen hours over several days -- but no Senate vote.

One thing I noted about the letter Lopez, who chairs the Senate Rules Committee, sent to Skandera, which Nott mentions in his story, is that Lopez takes another subtle shot at Attorney General Gary King, one of her rivals in the Democratic primary for governor.

Lopez said she requested certain information from the AG back in March, but "As of this date I have not received a response from Attorney General Gary King."

Didn't some wise columnist predict this sort of thing only a few days ago?

Here's the letter:

10-28-13 Letter from Sen. Linda Lopez to Education Secretary Designate Skandera 

Common Cause's Lobbyist Report

Common Cause New Mexico on Monday released its long-promised report on lobbying in the state Legislature. My story in today's New Mexican can be found HERE.

Where the campaign contributions from oil companies
 to NM politicians come from

With former state Sen. Dede Feldman, D-Albuquerque as one of the researchers, the report looks at lobbying efforts for four bills in the past sessions. (I wrote about two of those in my story.)

Among the findings in the report:

•  Six top lobbyists in the legislature have 20 or more clients

• 26 former legislators are now lobbyists.

• Lobbyist have spent three-quarters of a million dollars feeding, entertaining, and giving gifts to candidates for state office, over the past year and a half.

• Representatives opposing a bill to regulate oil and gas operations received three and one half times more contributions than those voting for it.

• Two thirds of oil and gas contributions to legislators come from companies based outside New Mexico.

• Special interests representing bankers and lawyers spent heavily on key committee members to block legislation over several years.

You can read and/or download the entire report below

Lobbying in the Land of Enchantment - Special Interests and their Hired Guns 

Webber is In for Governor

Santa Fe businessman and political newcomer Alan Webber had a simple answer Monday when asked whether he’s really going to run for governor.

“Yeah.”

Webber, 65, a co-founder of Fast Company magazine who has lived in Santa Fe since 2003, said he had filed his candidacy papers with the Secretary of State’s Office early Monday morning to run in the Democratic primary.

“I started looking at running for governor about a year and a half ago, but I didn’t really make a decision until about three months ago,” he told a reporter.

He said that before he made his decision he traveled throughout the state. “I wasn’t presenting myself as a candidate,” he said. “I was presenting myself as somebody with a lot of experience in business, economic development and issues like public education. … I head the same thing from people everywhere, whether it was Las Cruces or Pecos, and that is, the state’s not doing very well. The state’s in real trouble. The state’s at a standstill. I heard that more than once. And we’ve got to do something to get New Mexico moving again.

“I looked around at the Democratic slate and I felt very candidly that I was the one who could actually do the best job presenting a better vision for the state and could win the election for the governor’s office.”

Asked whether the fact that he’s a relative newcomer to the state will be a problem in the campaign, Webber said, “In New Mexico, questions will always come up: ‘How long have you lived here? Who are your people? How well do you know us?’ The flip side of that is everyone I’ve met in that period of time I was exploring the idea [of running] was incredibly generous. They didn’t ask me, `Who are you to be interested in New Mexico’s future?’ They said, `We’re really interested in New Mexico’s future, too, and if you are, welcome to the conversation.’ I’m sure it’ll come up. But I have to tell you, when I lived in Boston, people were really concerned that I didn’t come over on the Mayflower.”

Webber moved to New Mexico from Boston, where he edited Fast Company for 10 years. Previous jobs for Webber include editing the Harvard Business Review and writing speeches for Michael Dukakis when he was governor of Massachusetts.

The Martinez campaign was quick to respond to Webber's entry into the race: “Alan Webber represents the extreme fringe of the Democratic Party and his radical ideology, which has even included attempts to eliminate car use, is way out of step with mainstream New Mexicans," said Martinez spokesman Danny Diaz. He was referring to a memo Webber wrote in 1971 -- when he was in his early 20s and an assistant to the mayor of Portland, Ore.

Webber joins fellow Democrats Attorney General Gary King and state senators Linda Lopez of Albuquerque and Howie Morales of Albuquerque. Republican Gov. Susana Martinez is seeking re-election and is not expected to have any serious primary opposition.

Read more in tomorrow’s New Mexican. For more background on Webber, here's a story I wrote Friday.

Susana Seeks Southern Hospitality

Last week, Gov. Susana Martinez spent time politicking in Texas, Oklahoma, Colorado and Wisconsin.

She's starting off this week, however, in Dixieland, where she's raising money for her re-election.

According to the Associated Press, quoting Martinez's political advisor Jay McCleskey, the gov flew to North Carolina on Saturday. She had fundraisers there and in Georgia on Sunday.

Today, Martinez is raising the campaign bucks in Georgia and Mississippi.

Tomorrow she'll be in Arkansas before she heads back home to New Mexico.

McCleskey told AP that Martinez's campaign is paying all the travel expenses.

ROUNDHOUSE ROUNDHOUSE: Rumbles Beginning in Dem Primary

Two of the three Democratic candidates for governor were in the same room at the Roundhouse last week. But neither seemed to be in campaign mode.

Attorney General Gary King, the first Democrat to declare he wants to be the party’s nominee to take on incumbent Gov. Susana Martinez, was testifying, along with State Auditor Hector Balderas, before the Legislative Finance Committee about the investigation into 15 mental health providers under investigation for possible fraud. State Sen. Howie Morales, D-Silver City, who just last week joined the gubernatorial race, was there because he’s a member of the LFC.

No, there weren’t any obvious tensions showing between King and Morales. In fact, Morales wasn’t in the room very much during King’s presentation.

Knowing what I do about these two candidates, I rather doubt that it gets very nasty between them.

If there are any fireworks in the Democratic primary, my guess is that it will come from the third candidate, Sen. Linda Lopez, D-Albuquerque. In fact, just last week, Lopez took a swipe at King in a news release dealing with the behavioral health controversy.

For more on this, plus a sneak peak at U.S. Rep. Steve Pearce's upcoming autobiography CLICK HERE