Cash-starved NM agencies file emergency court appeal
July 31, 2013 by Dennis Grantham, Editor-in-Chief SHARE ON FACEBOOK SHARE ON LINKEDIN SHARE ON TWITTER SHARE ON GOOGLE MORE SHARING SERVICES | REPRINTS
Facing ouster, CEOs ask to see New Mexico’s fraud allegations before agencies are taken over
Eight of 15 New Mexico behavioral health agencies whose Medicaid payments have been held since June 24 based on “credible allegations of fraud” by state Human Services Department (HSD) Secretary Sidonie Squier have appealed a July 25 decision by federal Judge Christina Armijo to the Tenth Circuit Court. Last week, Armijo denied the agencies' request for a temporary restraining order that would have forced New Mexico to reinstate their funding and make available the details of an audit that is said to document millions in waste, fraud, and abuse.
Armijo’s decision stated that the agencies’ request for a temporary restraining order was denied because “plaintiffs have failed to fulfill their heavy burden to establish that they are entitled to the extraordinary remedy” that the TRO and a resumption of payments to them would provide. While Armijo noted that the agencies made a “substantial” case in support of two of the four points necessary to win such an order, she ultimately ruled against the agencies on all four points in the brief containing her decision.
However, in emergency appeal documents filed with the US Tenth Circuit Court on July 29, plaintiffs’ attorney Patric Hooper argued that “something is very rotten in the State of New Mexico’s Medicaid program.” In the appeal, Hooper stated that since the agencies’ initial July 3 filing in Armijo’s court, HSD’s payment stoppage—affecting $ 7 million in 2013 claims so far— has “made it virtually impossible for the organizations to continue to provide services.” It also has forced the closure of one agency and the impending closure of several more.
In the appeal, Hooper alleges that the agencies are being driven out of business. Their vulnerability to cash-flow problems “gave HSD the chance to commandeer their programs by installing five handpicked Arizona organizations to take over Plaintiffs’ businesses.” At the same time, the appeal argues that the agencies continue to suffer harm as referrals dry up, employees are laid off, and the details of alleged fraud remain hidden from view or from reply. To date, he says that none of the agencies have been given “any meaningful notice or opportunity to discuss any of the specific allegations against them.” ... Cash-starved NM agencies file emergency court appeal