Delegation Calls for Federal Investigation Into NM Human Services Department Suspending Medicaid Payments to Behavioral Health Providers

Statement

Today, U.S. Sens. Tom Udall and Martin Heinrich, and U.S. Reps. Ben Ray Luján and Michelle Lujan Grisham sent a letter to U.S. Health and Human Services (HHS) Secretary Sylvia Burwell calling for a thorough investigation of the findings in the Attorney General's report on the New Mexico Human Services Department's suspension of Medicaid payments to 15 nonprofit behavioral health providers. The letter also calls for Secretary Burwell to provide a response detailing which oversight options are available and what actions the agency plans to take in response to this serious situation.

The lawmakers also requested that HHS work with the State of New Mexico to ensure it implements critical policies and procedures to ensure its compliance with federal requirements for determining whether there is a credible allegation of fraud.

"Attorney General Balderas's findings confirm our longstanding concern that the well-documented irregularities surrounding HSD's decision to suspend payments, which was not required by federal law, has undermined the legitimacy of its entire audit process," the lawmakers wrote. "Furthermore, HSD denied providers' due process of law by indefinitely withholding payments while taking deliberate steps to preclude providers from challenging the charges against them. This callously disrupted care for New Mexico's most vulnerable."

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