SANTA FE, N.M. (AP) - A company providing some behavioral health services in New Mexico following a shake-up of the state’s network says it is losing money and needs to be paid more if it is to stay afloat.
Details about the financial health of Turquoise Health and Wellness were outlined in a report sent this month to the state Human Services Department and the managed care organizations that pay it, The Santa Fe New Mexican reported Monday https://bit.ly/1r1pEPS ).
The company is “currently not a financially viable organization on its own,” the Oct. 9 report states.
Turquoise was one of five Arizona firms hired by Gov. Susana Martinez’s administration last year following the abrupt termination of 15 New Mexico behavioral health providers suspected of Medicaid fraud.
The Arizona companies received about $24 million in transition costs to take over for the in-state companies. Turquoise received about $2.8 million in transition funds during the second half of 2013, according to state financial records.
Turquoise operates in Carlsbad, Clovis and Roswell. The company is a unit of Phoenix-based Lifewell Behavioral Wellness Inc.
The report submitted to the state shows Turquoise has endured staff turnover exceeding 50 percent. The company decried the “lack of qualified workforce” and lamented that “all areas (it serves) are rural/frontier and widely scattered.”
During the first six months of 2014, the report states the company lost $1.3 million and maxed out a $3 million line of credit from its parent company.
Six managed care organizations that receive funding from the state to pay behavioral health providers for services owe Turquoise more than $2.6 million for the fiscal year that ended June 30, according to the report.
It’s these same managed care organizations, and not the state, that Turquoise is asking for a rate increase, according to Human Services Department spokesman Matt Kennicott. He said the department scheduled a meeting with the managed care organizations at Turquoise’s request.
“The provider and the managed care organizations must negotiate with each other if they want higher or different rates,” Kennicott said.
The behavioral health care shake-up followed an audit that found $36 million in overbilling by the New Mexico companies. The findings have been challenged by Democratic lawmakers and the ousted providers.
The New Mexico Attorney General’s Office has also contradicted the audit. To date, the office has cleared two providers, although the investigation into one of them has been reopened.
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