New Mexico Attorney General: Pathways Inc., Investigative Report

On April 5, 2016, the New Mexico Attorney General released findings clearing Pathways, one of the final two behavioral health provider organizations accused in June 2013 of Medicaid fraud.  The findings have been forwarded to the New Mexico Human Services Department (HSD) for further action. The organization was among a group of 15 provider organizations accused of Medicaid fraud in June 2013 following an audit conducted by Public Consulting Group (PCG) that estimated that since 2009, the state had paid about $36 million for fraudulent claims. The audit was prompted by concerns raised in December 2012 by OptumHealth New Mexico . . .