Audit: NM mental health cos. in possible fraud
A new state audit says that 15 providers of mental health and substance abuse services failed to meet standards, overbilled the federal government by tens of millions and may have taken part in "potential fraudulent activity" by some health executives.
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Since: Jun 13
#1 Jun 24, 2013
Yikes! All of the psychotherapy coding changes that became effective 1/1/13 probably aren't helping either. Mental Health coding is a real art, too. In the rest of the US, many of these coders are paid a premium for what they know (how to get their docs paid LEGALLY and fully).
I don't have any inside knowledge about this particular situation, but part of me wonders if ALL of these charges are because of fraud.
Could at least part of this be due to ignorant, noncredentialed employees doing the medical coding?
#2 Jul 6, 2013
If it this frickin difficult,
then it is silly government rules and regs that do not make sense
#3 Jul 8, 2013
Medical coding and regulations related to health information do not come from "the government". It's just not that simple. Medical coding is standardized into a system, much like the Dewey decimal system for libraries. No system = chaos. The World Health Organization, the American Medical Association, and CMS all play roles.
Sorry. No easy sin eater here for the problems our country is facing.
#4 Jul 18, 2013
Why were only the non-profit providers audited and denied medicaid payments, while the for profit companies remain untouched? Many of these companies have already shut down operations and many more will close their doors before the investigation is concluded. Keep in mind that all 15 companies were denied payment based on an aggregate score of all 15 companies, and not based on the individual company's performance. So even the companies with little to no issues were denied payment. I believe this was the goal along, force the non-profits out of business so the for-profit companies could bring in their clients and thus be more profitable.
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