Settlement closes dark chapter

A dark chapter in our previous governor’s time in office is finally coming to a close with a recent $10 million settlement.

Six years after Gov. Susana Martinez’s administration accused 15 behavioral health providers of overbilling the state’s Medicaid program and freezing them out of their reimbursements, the state Human Services Department announced last week it has reached an agreement with five of the falsely accused agencies. According to an HSD news release, the state has now settled all 10 lawsuits that grew out of Martinez’s actions against the providers in 2013.

I’d say the state got off light. The five agencies had been seeking $27 million — and based on HSD’s egregious and destructive actions at the time, they probably could have held out for more.

In case you’ve forgotten, here’s what happened: In the summer of 2013, citing a sealed audit that alleged billing fraud, HSD froze the Medicaid reimbursements for 15 different behavioral health providers (and later severed their contracts with the state), and asked the Attorney General’s office to investigate. Meanwhile, HSD brought in new providers from Arizona to manage the state’s behavioral health services.

The AG’s investigation eventually cleared the providers of all criminal wrongdoing. The Martinez administration had claimed that as much as $36 million in Medicaid dollars had been mismanaged, overbilled or fraudulently charged, but AG Hector Balderas found nothing of the sort. But his conclusions vindicating the behavioral health agencies were too late for some of them, and they had already been forced to close their services because of a lack of Medicaid reimbursement funds.

Additionally, the press had to sue for the public release of the audit and its findings, and ultimately found the allegations to be comparatively weak and without substance.

The Arizona agencies — which, some have suggested, had ties to out-of-state contributors to Martinez’s 2010 election campaign — eventually withdrew their services from New Mexico, apparently unable to make enough money off their own Medicaid reimbursements to stay afloat under Martinez administration policies.

The human face to this outrage includes thousands of New Mexico men, women and children who suffer from mental illnesses or related disabilities. Many of them were left without access to the care and treatment they needed and had previously been receiving.

A documentary about all this, released earlier this year and titled “The Shake-Up,” included some emotional interviews with providers and patients. One counseling professional (from Easter Seals El Mirador, one of the five agencies in this latest settlement) estimated they had lost seven patients to suicide or drug overdose as a result of the state’s actions to shut down their services.

And that’s just one agency. God only knows how many others fell deeper into their illness due to a lack of available treatment.

Indeed, the Martinez administration’s actions went beyond politics. It was a moral lapse, in which money and power trumped the needs of some of the most vulnerable New Mexicans out there.

Tom McDonald is editor of the New Mexico Community News Exchange. Contact him at:

[email protected]