4 On Your Side looks at state's mental health audit

Posted at: 07/23/2013 8:35 PM
By: Gadi Schwartz, KOB Eyewitness News 4

An audit that blasted New Mexico mental health providers is drawing more scrutiny after the state auditor has been denied access to the report. 

The audit was done by an out-of-state company, Public Consultant Group in Boston, and effectively accuses more than a dozen New Mexico mental health care providers of fraud and overpayment. An audit summary provided by the state's Health and Human Services Department states the companies are "36 million dollars in definitive over payments have been identified."

But the word "definitive," is not sitting well with lawmakers of the companies that have been accused of fraud. State Senator Gerald Ortiz y Pino said the companies have not been specifically told what they have done wrong, and neither has the state auditor.

"If they are not willing to release the audit, they are not even letting the people who have been audited look at it, not even the state auditor, that is the first red flag," Ortiz y Pino said.

A "4 On Your Side" review of the audit executive summary found that the $36 million did not appear "definitive" but instead were "estimates" based on extrapolations from random samples that were reviewed by PCG.

"Well look, we can play semantics all you want, the bottom line is that the audit found millions of dollars in over payments in Medicaid money, and that's all money that could have gone to help low-income New Mexicans receive behavioral health services," said Matt Kennicott, Health and Human Services director of communications.

Kennicott said the department is comfortable with the findings because PCG used a larger sample size than required by the federal government.

Normally, the state auditor's office acts as the clearing house for audits conducted in New Mexico, but so far, HSD and the attorney general's office have declined to provide the state auditor with the report.

A spokesperson for the attorney general's office said they are working on getting the audit sealed through a court order before turning it over to the state auditor because they are conducting an investigation.

State Auditor Hector Balderas says it's ridiculous that he has not been able to see the audit and said he is considering filing a complaint with the federal Office of the Inspector General because the attorney general is preventing him from doing his job.

"It is my position that they're violating federal law at this point," Balderas said. "They're obligated to allow me to review and test how well they're protecting those federal funds."