New Mexico Behavioral Health Audit Overpayment Estimates Now A Fraction Of Initial 2013 Estimates

New Mexico Medicaid administrative hearings for a group of 15 behavioral health provider organizations accused in June 2013 of potential Medicaid fraud and overpayments have resulted in the state revising the estimated overpayments to a fraction of its initial $36 million estimate. In each fraud investigation, the state Attorney General’s Office found insufficient evidence of fraud, but in many did find evidence of Medicaid billing errors that led to overpayments. However, the amount of estimated overpayments has dropped significantly because the New Mexico Human Services Department (HSD) improperly included non-Medicaid claims in its review sample, and extrapolated the . . .