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New Mexico Telegram » Health

On NM health audit, firm didn’t follow normal practice

On NM health audit, firm didn’t follow normal practice

A Massachusetts firm that audited 15 health organizations in New Mexico last year normally gives companies it’s scrutinizing a chance to respond before issuing official findings. It is a common practice for auditors. Running the findings by staff gives organizations the opportunity to refute findings or address misunderstandings. It’s a way of ensuring the accuracy of an audit, among other things.   But the 15 New Mexico health organizations Public Consulting Group Inc. (PCG) audited last year didn’t … Read entire article »

Filed under: Featured, Health

Proposed legislation would protect health organizations

Proposed legislation would protect health organizations

A top state senator wants a law requiring the state to prove wrongdoing before cutting off government dollars to health-care organizations suspected of committing fraud or overbilling Medicaid. Sen. President Pro Tem Mary Kay Papen, D-Las Cruces, on Wednesday introduced the legislation to fellow lawmakers sitting on the Legislative Health and Human Services Committee during a hearing in Santa Fe. You can read Papen’s proposed bill here. The legislation is a reaction to the state Human Services Department’s (HSD) decision in 2013 to accuse 15 health … Read entire article »

Filed under: Featured, Health

State refused evidence that refuted audit, heath provider says

State refused evidence that refuted audit, heath provider says

A state agency citing potential Medicaid fraud refused to consider documents that could have cleared a health care provider of allegations that it had overcharged the government by as much as $4.3 million, the organization’s officials said this week. After the New Mexico Human Services Department’s decision to not consider the documents, the health care provider, Presbyterian Medical Services (PMS), faced a difficult choice: settle with the state or fight and possibly run out of … Read entire article »

Filed under: Courts, Featured, Health

News orgs appeal ruling that lets health audit stay secret

News orgs appeal ruling that lets health audit stay secret

By Heath Haussamen Two news organizations are asking the N.M. Court of Appeals to overturn a ruling allowing last year’s audit of 15 health organizations to remain secret. New Mexico In Depth and the Las Cruces Sun-News filed the appeal Tuesday. The news outlets contend that the audit should be released so the public can better understand actions that pushed the state’s behavioral health system into a chaotic transition. The N.M. Human Services Department (HSD) used the … Read entire article »

Filed under: Featured, Health, Open Government

Insurance head: Health insurance premiums to drop in 2015

Insurance head: Health insurance premiums to drop in 2015

Albuquerque Business First reports that many health insurance premiums in the state will go down next year for patients on the New Mexico Healthcare Exchange. The report comes after statements by John Franchini, the state Superintendent of Insurance, who told the weekly business newspaper that the rates will be, on average, 1 to 2 percent lower than in 2014. Critics of the Affordable Care Act said the law would create increased health insurance costs. Not all of the … Read entire article »

Filed under: Featured, Health

Martinez spox downplays meeting with anti-abortion activists

Martinez spox downplays meeting with anti-abortion activists

The Susana Martinez administration downplayed a meeting with members of Protest ABQ, a high-profile anti-abortion group. The group wrote that they had met with Martinez in a blog post today. The meeting came on August 16, after a gala for the Baby Brianna Foundation. The “meeting” description of the discussion by Operation Rescue may be overstated. According to a spokesman for Martinez, the meeting wasn’t anything significant. The emailed statement came in response to a question from NM … Read entire article »

Filed under: Featured, Health

Health audit can remain secret, judge rules

Health audit can remain secret, judge rules

By Heath Haussamen A state agency can continue to keep secret most of an audit it used last year to suspend funding for 15 health organizations and spark criminal investigations into potential Medicaid fraud, a judge ruled Thursday. The ruling marks the second time in nine months that Douglas R. Driggers, a district judge in Doña Ana County, has agreed with the state’s Human Services Department (HSD) and Attorney General’s Office (AG) that protecting an ongoing criminal … Read entire article »

Filed under: Featured, Health, Open Government

Health organization sues NM for ‘acting in bad faith’

Health organization sues NM for ‘acting in bad faith’

By Trip Jennings A health organization battling state fraud allegations is accusing the state of acting in bad faith by “improperly withholding” more than half a million dollars it contends it is owed. In a lawsuit filed in Santa Fe this week, Easter Seals El Mirador has asked a judge to order the state Human Services Department (HSD) to release the funds, saying it was cleared of fraud allegations by the Attorney General’s Office in late April … Read entire article »

Filed under: Courts, Featured, Health

Groups still collecting signatures for Santa Fe marijuana penalty reduction

Groups still collecting signatures for Santa Fe marijuana penalty reduction

While headlines have said that the effort to put a question of reducing penalties for possession of marijuana in Santa Fe to the voters, the efforts haven’t failed yet. The Santa Fe clerk’s office validated more than 3,500 of 7,000 signatures turned in by Reducing Marijuana Penalties in an effort to put the question on the November ballot. The effort requires 5,673 signatures for the question to go to voters. With 3,569 valid signatures, the group is … Read entire article »

Filed under: Featured, Health, Santa Fe

New Mexico to stay on federal health insurance exchange in 2015

New Mexico to stay on federal health insurance exchange in 2015

The state of New Mexico will remain on the federal exchange for individuals in 2015, the New Mexico Health Insurance Exchange Board announced today. Albuquerque Business First reported the news just before noon today. The board made the decision after a vote at today’s NMHIX board meeting. From Albuquerque Business First: Board members were told by its IT vendors that the project completed on time, but there were other problems. The NMHIX did not have a contract … Read entire article »

Filed under: Featured, Health