New Mexico Attorney General Releases Final Behavioral Health Audits, Clears Teambuilders & Pathways Of Medicaid Fraud Allegations

On April 5, 2016, the New Mexico Attorney General released investigation findings clearing Teambuilders Counseling Services, Inc., and Pathways, Inc., the final two behavioral health provider organizations accused in June 2013 of Medicaid fraud. The two organizations were 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, the state’s Medicaid behavioral health managed care organization. In . . .