Raúl Torrez | Attorney General

AG Balderas Unveils New Public Service Announcements Launching Statewide Medicaid Fraud and Facility Abuse & Neglect Detection Initiative

FOR IMMEDIATE RELEASE: July 26, 2017

Contact: James Hallinan (505) 660-2216

This is the first time an Attorney General in New Mexico has requested that the federal government allow the office to proactively search through data to identify patterns of fraud

Balderas: “This initiative will provide a renewed opportunity for state agencies and private sector stakeholders to work together to combat fraud in the Medicaid system and protect the most vulnerable members of our community from abuse, neglect and exploitation.”

Albuquerque, NM – This afternoon, Attorney General Hector Balderas announced a new statewide Medicaid Fraud and Facility Abuse & Neglect Detection Initiative that will utilize a new proactive approach of identifying patterns of fraud. Attorney General Balderas will also be contacting state agencies and Medicaid providers regarding the new initiative and asking for the partnership of both the providers and agencies in the new initiative. The Attorney General is also reaching out to the community for information through the unveiling of two new public service announcements that will air in the Albuquerque and El Paso markets. The new commercials will help New Mexicans better identify and report Medicaid fraud, and neglect and abuse in facilities.

View the commercials here: https://nmdoj.flywheelsites.com/media.aspx

“This initiative will provide a renewed opportunity for state agencies and private sector stakeholders to work together to combat fraud in the Medicaid system and protect the most vulnerable members of our community from abuse, neglect and exploitation,” said Attorney General Hector Balderas. “With strengthened partnerships and better information sharing, we will work tirelessly to investigate and prosecute Medicaid fraud and those who abuse or neglect the elderly and disabled.”

The Office of the Attorney General’s Medicaid Fraud Control Division was recently awarded a waiver from the federal government which will allow it to proactively look for fraud rather than wait for referrals. This will give the Office of the Attorney General the ability to detect potential patterns of fraud, including those in the long-term care industry. The office anticipates that this will allow investigators to see where there is room for improvement in the system and where large-scale fraud is occurring. This is the first time an Attorney General in New Mexico has requested that the federal government allow the Office of the Attorney General to proactively search through data to identify patterns of fraud. As part of this initiative, the office has developed systems that allow storage of the claims in-house, giving the Office of the Attorney General the ability to quickly and directly access the data.

“Protecting taxpayer dollars and care for vulnerable elderly and disabled individuals in our community is a priority for our office,” said Attorney General Balderas. “We are committed to developing innovative ways to address these problems, and work toward a more proactive model.”

Attorney General Balderas will be asking the agencies and organizations involved in the detection of fraud to commit to cooperation in program integrity efforts in order to more effectively protect the Medicaid system. These efforts would include sharing more information about the tools and methods used in detecting Medicaid fraud in order to create new strategies to combat the fraud. The Attorney General will express that both state agencies and providers have the same responsibility to identify fraud, protect vulnerable people in our
community, and have the same common goal to stop fraud, abuse and neglect.

Approximately 40% of New Mexicans access Medicaid benefits and Medicaid dollars pay for seven in ten babies born in the state. With threatened federal cuts to Medicaid, and in a time of increased budget crisis, every dollar counts in New Mexico.

In less than three years, a third of our population will be over the age of sixty. Recently New Mexico was ranked as low as 39th with percentage of population over 65, but in only ten years New Mexico is projected to be ranked 4th in the United States.

Click here to view the commercials: https://nmdoj.flywheelsites.com/media.aspx

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Raul Torrez

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