Two NM Behavioral Health Providers to Repay $4.2M in Medicaid Overbillings

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November 4, 2013; Ventura County Star


In New Mexico—the state, according to the latest SAMSHA report, with the highest per capita rate of mental illness in the country—the status of the system dealing with those problems is still unclear. As NPQ readers may recall, 15 behavioral health agencies had their Medicaid payments suspended in June and the contracts for serving the patients of those agencies were transferred to Arizona based agencies. The 400-page audit on which that action was taken has never been reviewed by the agencies in question or by local press.

Now, it is being reported that two of those agencies are being asked to repay $4.2 million in overbillings, with $4 million to be collected from Presbyterian Medical Services and $240,000 from Youth Development Inc. They must also sever ties with TeamBuilders Counseling Services Inc., which remains under investigation; only then, apparently, will the two agencies be allowed to resume services.

Agency relationships with TeamBuilders appear to be at issue in the investigations. That agency is still closed, and it was reported in August by the Albuquerque Journal that that agency was being run by a couple who brought home a combined $1.5 million “in salaries and other income.” The paper then alleged that, “Shannon and Lorraine Freedle, operators of TeamBuilders Counseling Services Inc., derived much of that income from leases paid by the nonprofit to holding companies owned in full or in part by the Freedles and other TeamBuilders officers, according to a state-commissioned audit—Ruth McCambridge