HHS Watchdog Presses New Mexico Over Nursing Care Payments

Federal watchdogs urged New Mexico to refund nearly $120 million in Medicaid payments that were improperly made to managed care organizations for nursing services.

In a report published Monday by the Department of Health and Human Services Office of Inspector General, federal auditors examined $3.8 billion in payments New Mexico made to managed care plans for at-home nursing care from 2014 through 2018.

The study determined that New Mexico didn’t recoup $139.2 million from managed care organizations for Medicaid enrollees who didn’t use at-home nursing care within 90 days of being approved for those services as required under the state’s ...