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Reprieve for 2 behavioral health firms

Two of the behavioral health nonprofits whose Medicaid money was cut off by the state after an audit are likely to have that funding restored and won’t be replaced by Arizona providers, a spokesman for the Human Services Department said Friday.

Matt Kennicott said it’s “looking more and more likely” that Santa Fe-based Presbyterian Medical Services and Youth Development Inc. in Albuquerque will instead undergo intensive oversight of their management and billing practices.

A dozen other New Mexico nonprofits that were among 15 recently audited are slated to be taken over by Arizona companies, with 10 of those transitions already underway or about to start, the HSD confirmed this week.

All 15 are under investigation by the attorney general after HSD turned over findings of a special audit it commissioned. The HSD said the audit showed overbilling, mismanagement and possible fraud among the providers, and HSD abruptly froze their funding in late June.

Kennicott said it was too problematic to have Arizona behavioral health companies take over Presbyterian Medical Services and YDI because the two nonprofits offer services that go beyond behavioral health. Presbyterian Medical Services, which has 40 sites around the state, also provides physical and dental health care; YDI has a Head Start program.

Presbyterian Medical Services CEO Steven Hansen said the agency has been in talks with HSD and Arizona-based La Frontera, trying to figure out “the most realistic way to improve what PMS is doing in behavioral health, and comply with what HSD wants, and use the expertise of La Frontera.”

“The train’s kind of left the station. … It’s not comfortable, but we’re trying to make the most of it,” Hansen told the Journal.

The 15th nonprofit, Service Organization for Youth in Raton, had its Medicaid funding restored shortly after it was halted and is getting technical assistance and training from an Arizona provider.

In an update Thursday to the New Mexico Behavioral Health Interagency Purchasing Collaborative, HSD officials said the Arizona providers they brought in are hiring, on average, 90 percent of the staffs of the New Mexico nonprofits of which they’re taking control.

There have been complaints about disruptions in services, although the administration of Gov. Susana Martinez says the transition to new managers is going smoothly.

“We are working on making sure consumers are safe, and that services are in place throughout the network,” said Diana McWilliams, director of HSD’s Behavioral Health Services Division.

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Categories: Medicaid Watch