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MaineCare Payments Suspended to Two Mental Health Providers
09/30/2013   Reported By: Patty B. Wight

Two mental health service companies in central and midcoast Maine have suspended MaineCare services because of allegations of fraud. The state of Maine has stopped payments to Umbrella Mental Health and AngleZ Behavioral Health Services. As Patty Wight reports, the suspension leaves about 500 Mainers in search of care.

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MaineCare Payments Suspended to Two Mental Health
Originally Aired: 9/30/2013 5:30 PM

The two health service companies have locations in Augusta, Winthrop, Damariscotta and Wiscasset. And Maine Department of Health and Human Services spokesman John Martins wants to make one thing clear about the state's suspension of MaineCare payments to them:

"Nobody is losing MaineCare services. What basically is happening is people will have to get their services provided elsewhere," Martins says.

The suspension took effect on Sept. 25th, after someone somewhere uncovered what's being called a "credible allegation of fraud." Martins can't elaborate on exactly what kind of fraud, but he says allegations can originate from claims and audit data, or a hotline tip. Allegations are passed on to agencies, like the Attorney General's Office and the Department of Justice, which determine whether they're credible.

"If they do, they notify our department, and by federal law and state statute, we have no choice but to suspend the payments until an investigation has taken place," Martins says.

"Unfortunately, the government investigation protocols prevents us from learning why the suspension has occurred," says Annalee Morris, the CEO of AngleZ Behavioral Health Services, which provides outpatient therapy, medication management, and community integration services.

Morris says news of the suspended payments came as a complete shock. She says she's cooperating with authorities, but has appealed the allegation, and been told it will be a week to 10 days until the appeal is reviewed. In the meantime, Morris says, she's had to lay off most of her 87 employees.

"We are running a small amount of employees that are dealing specifically with the clients that are most in need, and are most vulnerable at this point. And we're just hoping that payments will resume in the very near future," she says.

AngleZ deals exclusively with MaineCare patients, so with those payments suspended, Morris says she can likely only retain the remaining employees for just a week. She says the focus now is on helping clients transition to different providers, a prospect that Helen Bailey of the Disability Rights Center says can be particularly distressing.

"Mental health services, especially these types of mental health services, is all about relationships, and so it's really disruptive to have to change relationships," Bailey says.

DHHS is also working to find care for affected clients. The Department of Labor has deployed its Rapid Response team to help affected employees determine their next steps. Umbrella Mental Health Services declined comment for this story.


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