AG clears second provider of fraud in behavioral health audit

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Attorney General Gary King has cleared another non-profit behavioral health provider of fraud allegations leveled by the governor’s administration:


Attorney General Gary K. King

Tuesday, May 6, 2014


AG’s Probe Finds No Fraud in Health Provider’s Audit

Easter Seals-El Mirador Cleared of Fraud but Overbilling Found


(ALBUQUERQUE)—New Mexico Attorney General Gary King says his investigation found insufficient evidence of fraud by Easter Seals El Mirador , one of the health organizations accused by the state Human Services Department of “credible allegations of fraud” last June.


“Although our investigation found no actionable evidence of fraud, we did discover that Easter Seals El Mirador overbilled Medicaid in the amount of $34,126.19,” according to the Attorney General.


AG King says it is now up to HSD to take whatever action deemed appropriate to deal with the improper billing.  A full report by the Attorney General’s Medicaid Fraud & Elder Abuse Division will be provided to HSD.


More than a dozen other health and human services providers were accused of fraud and had their funding revoked as a result of allegations contained in audits and reports received by HSD.  The Attorney General’s Office has been investigating the claims, using the HSD information as a starting point for its own probe.

King previously cleared another provider of wrongdoing.   Last summer, The Martinez administration abruptly cancelled state Medicaid contracts with 15 non-profit behavioral health providers saying an internal audit had found evidence of fraud in each.

State Auditor Hector Balderas has found discrepancies in the administration of the audit as well.