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King trails most in Medicaid fraud recovery
Attorney General Gary King (Photo by Heath Haussamen)
In 2010, Attorney General Gary King’s office recovered 53 cents for every $1 it spent to fight Medicaid fraud, the Albuquerque Journal is reporting.
Only Alaska had a worse record than New Mexico, according to the newspaper. Leading the pack was Missouri, which recovered more than $31 for each $1 spent. The national average was a recovery of $10 for every $1 spent.
From the newspaper:
“If New Mexico’s Medicaid fraud unit had performed just average when compared with units in other states, it would have collected $18.5 million from criminal and civil defendants in the 2010 federal budget year. Instead, it brought in less than $1 million while spending about $1.8 million on its operation.
“And, just so you know, there is a lot of Medicaid fraud going on in New Mexico.
“By one estimate, there is about $75 million worth of fraud each year, and providers – those are the folks the AG’s Medicaid fraud unit is supposed to go after – account for 80 percent of the $75 million.”
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Here’s King’s response:
“The AG noted that the responsibilities of the Medicaid fraud unit include investigating and prosecuting elder abuse but said such cases typically don’t produce a financial recovery.
“…Also in his response, King said New Mexico generally recovers less in Medicaid fraud than other states because of its heavy reliance on managed care organizations to deliver benefits.
“The AG agreed with the review that the Medicaid fraud unit and the Human Services Department, which runs Medicaid, need to communicate better on referrals.”
“King also agreed to conduct an internal review of how the unit prioritizes cases and allocates staff.”
Read the full article here.
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Hey Gary King, how’s that Mary Herrera investigation coming along?
sorry that should be King hasn’t trotted out…
What? It has been almost a week and King has trotted out his mouthpiece Sisneros with the same old excuses. Must be King knows these facts are undisputable. How much more damage at the cost of the taxpayers and victims will the king group cause? It is becoming egregious.
How can anyone be surprised.
Second only to allowing New Mexico’s criminal political class to continue, this is a prime example of yet another King-size failure.
King, you have some mighty important questions to answer. Tick tock.
I would say it is AG Gary King’s incompetence, not the staff’s. Some rank and file employees stayed on from one administration to the next. I do not think those employees should get the blame for the mess their boss has created, but he and his appointees do. To my opinion AG King has a habit of appointing political pals to positions that they have little experience in, including in this division. The Medicaid Fraud division in particular is one where bad management appears to have caused serious problems. Under the previous AG Patricia Madrid Administration, the Medicaid Fraud division won multiple awards as a national leader in recovering funds. Under AG Madrid, that division was headed by Cathy Vincent, who I believe works for the Santa Fe DA’s office now.
Maybe the current disaster something to do with this? – http://www.saonm.org/media/audits/305_Office_of_the_Attorney_General_FY2008.pdf
It is the 2008 state audit of AG King’s office and pages 65 to 67 show three major audit findings on King’s Medicaid Fraud division alone including:
1) Deficit Cash Balance (Significant Deficiency) of $(340,664)
2) Due from Federal Agencies Not Reconciled (Significant Deficiency)
3) Deficit Fund Balances/Budgeting. The deficit amount was $63,270
As a direct result of these major audit findings, the New Mexico taxpayers had to cough up $300,000 “To reimburse the U.S. department of health and human services for audit findings in the medicaid fraud” according to the final signed version of House Bill 2, state budget 2009 legislative session. You can see on page 238 to 239 here http://www.nmlegis.gov/Sessions/09%20Regular/final/HB0002.pdf
So the bottom line is King has known he had a problem with this division since at least 2008, yet it gets worse. The division continues to lose money instead of collect money. King has shown he has no skills as an executive, administrator, litigator or prosecutor. Can you imagine what would happen to this state if he gets elected as governor?
Does this mean the King’s staff is just as incompetent as Gary King?