Attorney General Of New Mexico

HECTOR H. BALDERAS ELIZABETH A. GLENN
Attorney General Chief Deputy Attorney General

February 8, 2016

Via E-mail and Hand-delivery
Honorable Members of the Legislature
New Mexico State Capitol

Santa Fe, NM 87501

Re: Behavioral Health Investigations
Dear Honorable Members of the Legislature:

I am writing to provide you with information regarding progress on the investigations conducted
by the Medicaid Fraud Control Unit, pursuant to its authority under 42 CFR ?1007.11, of the
?fteen behavioral health providers referred to this Of?ce pursuant to an audit conducted by the
Public Consulting Group (PCG). Based on the results of the PCG audit, the Human Services
Department (HSD) determined that there were credible allegations of fraud and referred the
cases to this Of?ce for further investigation.

From the time I took over the Of?ce of the Attorney General, I have made it a priority to
complete the remaining twelve behavioral health investigations, and to bring transparency to that
process. After releasing the PCG audit with minimal redactions, I requested additional
investigative resources and received authorization to use the Of?ce of the Attorney General
Consumer fund in the amount of $1.8 million to contract with an experienced forensic audit ?rm
to assist in the completion of the investigations. An RFP was issued and as a result of that
process, auditing ?rm RSM was selected.

At this time and ahead of schedule, my Of?ce, in collaboration with RSM, has completed ten of
the twelve remaining investigations. The following ten provider investigations have been
completed: Border Area Mental Health Services, Partners in Wellness, Youth Development, Inc.,
Southern New Mexico Human Development, Hogares, Families and Youth, Inc., Counseling
Associates, Southwest Counseling Center, Presbyterian Medical Services (PMS), and Valencia
Counseling Services.

While we did ?nd some regulatory violations, there did not appear to be a pattern of fraud for

any of the ten completed investigations. Since we received these referrals from HSD as credible
allegations of fraud, we primarily based our investigations on issues raised in the referral. We

Santa Fe, NewMexico 87504-1508 (505)827-6000 

came to different conclusions on many of the alleged violations cited in the PCG report, and
ultimately did not find that the violations that we were able to substantiate re?ected a deliberate
or intentional pattern of fraud. These investigations will now be forwarded to HSD for any
administrative action they deem appropriate. The ten completed investigations are available on
the website of the Office of the Attorney General at 

There are two remaining investigations: TeamBuilders and Pathways. These two investigations

are ongoing and will require that we take additional time in order to ensure that our conclusions
are sound.

Sincerely,

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Hector H. Balderas
New Mexico Attorney General