Albuquerque Journal

4th agency leaves NM

5 firms contracted in Medicaid shake-up

- BY DEBORAH BAKER

Another of the Arizona behavioral health companies brought in three years ago after the Martinez administra­tion ousted local providers says it will leave New Mexico.

SANTA FE — Another of the Arizona behavioral health companies brought in three years ago after the Martinez administra­tion ousted local providers says it will leave New Mexico.

Valle del Sol gave notice to state officials in a letter dated Wednesday that it is terminatin­g its agreements and wants to pull out as soon as possible.

It will be the fourth of five Arizona companies to leave.

The firms provided services to the mentally ill and addicted after Gov. Susana Martinez abruptly shut down Medicaid funding to 15 New Mexico nonprofits, accusing them of overbillin­g and mismanagem­ent and referring them to the attorney general for possible fraud.

A dozen of those providers were replaced by the five Arizona firms.

The Office of the Attorney General cleared all the nonprofits of fraud following investigat­ions, but many were driven out of the behavioral health business.

Valle del Sol cited financial losses stemming from “high rates of claim denial and continuing deteriorat­ion of rates paid for services.”

Its parent entity has subsidized its New Mexico operations by more than $4 million but won’t continue to do so, according to the letter from a Phoenix law firm representi­ng the company.

Valle del Sol intends to provide services for the next 120 days “or whatever shorter transition period can be coordinate­d,” the letter said.

But it added that “the loss of employees that will likely happen following announceme­nt of this terminatio­n and the continued revenue shortfalls may cause the provider to close its doors sooner.”

Expediting payment of claims could help the company continue to offer services during the transition period, the letter said.

Valle del Sol has sites in Bernalillo, Española, Grants, Los Lunas, Moriarty, Raton, Santa Rosa and Taos.

A spokesman for the Human Services Department said Thursday that behavioral health agencies were largely exempted from the Medicaid provider rate cuts mandated in the current year’s budget.

“We will work with Valle del Sol, one of dozens of behavioral health agencies in New Mexico, and hope they maintain their operations here, which account for less than 2 percent of behavioral health services,” Kyler Nerison said in a statement.

If there is a transition, he said, the department will coordinate with the managed care organizati­ons that contract with the providers “to ensure access to care is not interrupte­d.”

Critics of the 2013 shake-up said it was unfounded and that it disrupted services to a vulnerable population.

Agave Health Inc., La Frontera, and Turquoise Health and Wellness ceased their New Mexico operations earlier.

Newspapers in English

Newspapers from United States