I am writing today to announce the closure of the New Mexico Independent. After three and a half years of operation in New Mexico, the board of the American Independent News Network, has decided to shift publication of its news…
While environmental activists played their part yesterday during demonstrations at the capitol building, going so far as to dress up as solar panels and to sing the tune of “You Are My Sunshine,” their counterparts, the anti-cap-and-trade contingency who has…
Roughly one quarter of University of New Mexico students are unimpressed with the state’s flagship public school, according to a survey that questioned college students about their higher education experiences.
In an extraordinary move, Gov. Bill Richardson on Monday directed a state agency that oversees behavioral health services to put the state’s $1 billion contract out to bid.
Richardson’s directive to the New Mexico Behavioral Health Collaborative comes seven months into the troubled tenure of Optum Health Care.
Optum took over the state’s four-year, behavioral health contract in July 2009. But Optum’s performance has not lived up to state officials’ expectations, especially after it was discovered that hundreds of providers statewide had to wait up to several months to get paid for services already rendered.
The problem was Optum Health’s electronic claims management system, which the company had touted as a way to promptly pay nonprofits and others working with the mentally ill and those struggling with substance abuse. The system failed under the crush of real-world use soon after it went live July 1; the volume of invoices and claims that flooded the system were much greater than the test sample of claims the state used to conduct its readiness review.
The problems left many providers cash strapped and disillusioned. The state recently reached an agreement whereby Optum would pay $1.5 million into two separate funds in lieu of a penalty.
In a statement Monday, Richardson downplayed the significance of Optum’s problems in the decision to go in search of a new behavioral health provider.
“The State faces difficult budgetary times and, in light of these challenges, the way in which the services that the Behavioral Health Collaborative provides to New Mexican’s are paid for and delivered needs to be evaluated,” the Governor was quoted as saying in a news release. “The focus should be on the most efficient and effective manner of administering and delivering these services, while maintaining the highest level of quality.”
Problems with Optum’s transition contributed to the state’s decision to seek proposals, acknowledged a spokeswoman for the New Mexico Behavioral Health Collaborative.
But it wasn’t the only reason, she said.
“Issues at Optum are certainly there,” said spokeswoman Betina McGonzales McCracken. “But the fact that we have a new RFP has to do with the budget, Medicaid redesign, and health care reform.”
The state, struggling financially, is trying to save money in the Medicaid program, the low-income health insurance program. Behavioral health services are funded through Medicaid, which is jointly paid for by the federal and state governments.
Also the state is changing policies in anticipation of whatever health care reform package comes out of Washington, McCracken said.
Optum would be free to bid on the state’s new behavioral health contract, McCracken said.
Optum took over from Value Options, which last year challenged New Mexico’s decision to contract with Optum despite Value Options’ bid to keep the work.
Value Options on Monday reacted to the news of a new contract process with little fanfare.
“We’re eager to help address New Mexico’s need for an efficient behavioral health care system, and we look forward to learning about the requirements and being part of the bid process,” said Lon Wagner, director of communications for Value Options.
At least one provider welcomed the news of Monday’s decision
“The administration’s decision to reissue this RFP reflects a recognition of the need to do something different in our system, and now this RFP offers the state the opportunity to actually change the way they are approaching administration of the Behavioral Health system,” said David Ley of New Mexico Youth Provider Alliance, a coalition of providers who work with adolescents.
McCracken, the Collaborative spokeswoman, said it could be a year before the new behavioral health provider is in place and Optum will remain the state’s behavioral services administrator until the new contract is signed.
“Getting a (request for proposals) this spring could be a quick turnaround,” she said, adding that proposals likely would come in the summer and fall. “Nothing would be changing until probably this same time next year.”
