Martinez owes New Mexicans an apology for Medicaid freeze

COMMENTARY: Good leaders apologize when they make mistakes. I accepted Gov. Susana Martinez’s apology for her pizza party debacle in December in part because such humility from elected officials, given the pressure to appear perfect in our scandal-hungry society, is rare.

Heath Haussamen

Heath Haussamen

Now Martinez owes New Mexicans an apology for a devastating decision by her Administration. Thus far, she’s not offering one.

When the Martinez Administration falsely insisted it had no choice but to freeze Medicaid funding to 15 behavioral health organizations in 2013, it was clear that the Administration was, at best, making a huge mistake. The Medicaid freeze forced health providers out of business. It put tens of thousands of New Mexicans needing help with issues like depression and suicidal thoughts at risk by disrupting services and creating chaos.

It took a colleague of mine a few hours of reporting to figure out that the Administration could have continued funding the organizations to ensure services weren’t disrupted while law enforcement investigated possible fraud.

Either the Martinez Administration didn’t understand the federal rules or, even worse, it was trying to deceive New Mexicans. Long after we at New Mexico In Depth, where I was working at the time, reported the truth – that funding could have continued during the investigation – the Administration wrongly insisted it had no choice and downplayed disruptions in services.

The Administration has defended itself by pointing out that two health organizations returned $4.24 million in alleged overpayments in exchange for restored funding. Presbyterian Medical Services, which repaid $4 million, disputed owing that much but said its aim was to preserve “critical safety net behavioral health services” and jobs.

With its funding held hostage, Presbyterian gave in. Others that fought are bogged down in litigation. Many have gone out of business or limped along.

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Five Arizona companies brought in to fill the gap in services have also struggled. Three have since quit providing services in New Mexico, sparking additional transitions and disruptions.

Now the attorney general has cleared all 15 New Mexico providers the Administration accused of “credible allegations of fraud” in 2013.

All 15. No fraud.

There were some billing problems. Some organizations owe money. That could have been addressed without putting people at risk.

The way the Martinez Administration responded to concerns about fraud has been a complete disaster.

Ever since, the Administration has engaged in a campaign of misinformation, spin, and secrecy. Martinez’s response to all 15 organizations being cleared of fraud was deflection: “Medicaid funds should be used to provide basic health care for those in need, and I will never turn a blind eye to wealthy CEOs who break the public’s trust and do things like funnel public money to family members and squander tax dollars on private planes,” she said.

No acknowledgement that she’s even aware of the damage her Administration has caused.

One of the Arizona providers that has quit working in New Mexico is suing United Healthcare and its subsidiary, OptumHealth New Mexico – the go-between at the time that distributed state Medicaid funds to providers. OptumHealth covered up its own problems by blaming the 15 New Mexico health organizations, La Frontera alleges.

Maybe the Martinez Administration was duped. Or maybe the truth about why the Administration froze funding is much worse.

Regardless, Martinez needs to apologize for crippling this important government safety net. And she must foster a transparent, honest discussion about how we fix her Administration’s mess.

A prior version of this commentary incorrectly stated that Presbyterian Health Services, not Presbyterian Medical Services, repaid the state $4 million. Presbyterian Healthcare Services is not affiliated with Presbyterian Medical Services, the company that repaid the $4 million. NMPolitics.net regrets the error and has corrected this commentary.

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