Judge Says New Mexico Wrong To Withhold Medicaid Funds From The Counseling Center During Administrative Appeal Of Fraud Allegations

On October 23, 2015, a New Mexico state judge said the state Human Services Department (HSD) was wrong to withhold Medicaid reimbursements from behavioral health provider organization, The Counseling Center, during an internal administrative review of a Medicaid payhold imposed in 2013 due to an allegation of fraud. The fraud allegation was based on an audit by Public Consulting Group (PCG) of the state’s largest behavioral health provider organizations; upon reviewing the audit findings, HSD said the findings for 15 provider organizations represented a credible allegation of billing fraud. HSD referred its allegation to the state Attorney General and . . .