By Deborah Baker / Journal Staff Writer
An advocacy group for the disabled says that because of the recent upheaval in New Mexico’s behavioral health system, the state is not meeting its legal obligations to the Medicaid-covered mentally ill and addicted.
Disability Rights New Mexico said in a letter to the Human Services Department that the state and its contractors are not maintaining an adequate network of providers, nor are they providing services promptly.
The letter, sent Sunday, was released to legislators Monday at a meeting of an interim committee.
The meeting was marked by now-familiar testy exchanges between lawmakers and HSD officials, with Sen. Gerald Ortiz y Pino, D-Albuquerque, saying committee members have the impression “it is total chaos out there.”
Sen. Howie Morales, D-Silver City, said patient privacy may have been violated. He said a document-scanning company that is putting patient records on a digital database for the new providers conveyed the information in an unsecure, unencrypted email containing the names of 2,000 to 3,000 clients — some of them being treated for drug and alcohol problems.
Such a privacy violation could subject the state to financial penalties, Morales said, and the Behavioral Health Subcommittee agreed to forward his request for an investigation to the full Health and Human Services Committee.
The HSD says an audit of 15 major New Mexico behavioral health providers showed overbilling, questionable business practices and possible fraud, and it has replaced 12 of them with Arizona companies. The attorney general is investigating the 15.
HSD defends its suspension of Medicaid funding to the providers and its handling of the transition to the new companies. Diana McWilliams, director of HSD’s Behavioral Health Services Division, told the committee that based on the information it has gotten, “things are going well.”
Disability Rights New Mexico cited a litany of complaints. Among them: Albuquerque agencies’ clients having to wait a month for requested appointments although a regulation limits the wait to 14 days; and at least 200 fewer children and their families being served by the new Open Skies as were served by the previous provider, Hogares.
While the disability group stopped short of threatening a lawsuit, executive director Jim Jackson told the Journal the suspended or significantly delayed services that are being alleged are “not allowable under federal law.”
The letter said HSD should immediately identify how many people who were previously getting behavioral health services are no longer getting them, and why; reach out to them; and make sure services are provided.
HSD’s deputy general counsel, Larry Heyeck, said he had just received the letter and had no immediate response to it.
McWilliams told the panel HSD is trying to put together hard data on the impact of the transition.
“All of us have been inundated with anecdotes, but we need data,” McWilliams said.
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The letter from Disability Rights New Mexico can be found here.
Read more: http://www.abqjournal.com/272333/news/advocacy-group-state-not-meeting-medicaid-obligations.html