State seeks replacement for departing Agave Health

April 26--Gov. Susana Martinez's administration is trying to line up a behavioral health care company to replace Agave Health Inc., the Arizona firm that announced earlier this month it will stop providing services to some 3,000 low-income patients in Northern New Mexico.

The patients are among a growing number of New Mexicans seeking help with mental illness and addictions through a publicly funded network that the administration upended three years ago when it accused 15 New Mexico firms of potential Medicaid fraud and replaced them with Arizona companies.

The Associated Press reported Monday that Human Services Department data shows the number of New Mexicans accessing behavioral health services in 2015 doubled from the previous year to 153,000. State officials attributed the increase to Gov. Martinez's 2014 expansion of Medicaid.

As the numbers climb, advocates are concerned about the ability of the state to keep pace given a lack of providers in the wake of the shake-up of New Mexico's mental health care system, the Associated Press reports.

The state Attorney General's Office eventually cleared all of the New Mexico firms, finding no patterns of fraud, only regulatory violations. However, some of those agencies are still fighting with the Human Services Department in lawsuits and in administrative hearings over Medicaid payments.

Shannon Freedle, chief executive officer of Santa Fe-based Teambuilders Counseling Services Inc., which Agave replaced during the shake-up, said recently he asked the state Human Services Department about the possibility of getting his business back. But the department wouldn't entertain his inquiries, he said, and subsequently sent Teambuilders a letter demanding it repay what the state claims were millions of dollars in Medicaid overpayments.

Meanwhile, the state has drafted a four-page request for information from potential replacements for Agave, which will be the third of five Arizona companies brought to New Mexico during the shake-up to subsequently pull out of the state. The document asks that interested firms describe strategies for implementing services that Agave has provided in Santa Fe, Albuquerque, Las Vegas, Los Lunas, Taos, Española, Raton, Rio Rancho, Clayton, Santa Rosa and Grants. The work would include therapy and crisis intervention.

It was unclear Monday whether the state ever posted the request publicly or which agencies might have responded to it. Kyler Nerison, spokesman for the Human Services Department, did not reply to requests for comment.

The transition from Agave in coming months could represent another disruption for patients who are enrolled in Medicaid, the state-federal program that provides health insurance coverage for some 850,000 low-income New Mexicans.

"They lost one of the few stable things in their lives," Freedle said of clients now under Agave.

Kate Wall Gantz, a therapist for Agave, said after a recent public forum that her clients were "scared" by the announcement that they could lose another provider. Some of her clients have since canceled and have not showed up to appointments.

"It's horrible," she said. "The government is playing with people's lives."

In past transitions of behavioral health care providers, new management have retained staff, such as therapists.

The Associated Press on Monday also reported an Eddy County Magistrate judge last week dismissed Medicaid fraud charges against Carlsbad Mental Health Center employees Noel Clark, Darril Woodfield and Michael Stoll.

State officials have previously said the Carlsbad case led them to take a deeper look into possible Medicaid overbilling in New Mexico's behavioral health care provider network.

Justin Horwath can be reached at 505-986-3017 or [email protected].

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