NM Ethics Commission delivers governor a ‘stunning defeat’

In what the Santa Fe New Mexican described as a “stunning defeat,” Democrat Gov. Michelle Lujan Grisham’s halting of awarding billion-dollar Medicaid contracts to providers who had followed the state’s procurement process and scored the highest bids, the state Ethics Commission reversed her action.

The State Ethics Commission investigated the cancellation of the Request for Proposals (RFP) on April 20, 2023. They contended that this cancellation violated the Procurement Code, leading to the authorization of a civil enforcement action by their Executive Director, according to a press release.

During a special session held on Thursday, the commission entered into a settlement agreement to resolve the previously authorized civil action related to the violations of the Procurement Code by state officials and employees. However, it was not revealed whether an ethics complaint prompted this investigation.

Tom Garrity, a representative of the commission handling public relations, stated via text message to the New Mexican, “The commission does not have anything to add beyond the press release and settlement agreement.”

Democrat State Senator George Muñoz of Gallup criticized the Governor’s intervention in the procurement process, stating that the process should remain open and transparent, with no alteration of the rules.

The press release highlighted that the state allocates approximately $8 billion annually to Medicaid, catering to almost half of New Mexico’s population by providing healthcare services.

The 11-page settlement agreement strongly denied the Ethics Commission’s allegations of violating the procurement code. It dismissed claims of wrongdoing, damages, and any form of liability, including Procurement Code violations.

The Governor’s stance, as outlined in the agreement, pointed fingers at the Department, asserting, “The scores for all applicants raised significant concerns as to whether any of the bidders would be able to provide seamless, robust, and high-quality health care to New Mexicans.” This led to the decision to cancel the RFP and reissue the contracts with stricter requirements and benchmarks for service providers, based on the Department’s belief that the Procurement Code did not apply to the RFP process.

Caroline Sweeney, the Governor’s press secretary, emphasized the necessity for high-quality and affordable healthcare coverage for over 930,000 New Mexicans served by Medicaid. Sweeney declared, “The status quo is unacceptable. MCOs have not been doing their part to build network adequacy across the state, and when we pay them over $7 billion annually, we have a responsibility to demand excellent performance and patient access — and they must deliver.”

Per the settlement agreement, the department will issue notices of intent to award contracts to the four initially selected providers: Blue Cross and Blue Shield of New Mexico, UnitedHealthcare of New Mexico, Molina Healthcare of New Mexico, Inc., and Presbyterian Health Plan. Western Sky Community Care, which competed for the contracts but was not recommended, will be informed that it wasn’t chosen for an MCO contract award.

Contracts with the four winning bidders will be negotiated, with a commencement date of July 1, 2024, following the RFP process, New Mexico’s Procurement Code, and relevant state procurement regulations.

Presbyterian will be notified of being awarded the contract to offer managed care for children in state custody.

The acting human services secretary Kari Armijo explained, “We will be negotiating contracts that reflect these improvements with the expectation of achieving better health outcomes for Medicaid customers.”

The Governor’s decision to reorder the procurement process drew bipartisan criticism, compounded by shifting explanations from the Governor’s administration regarding the reasons for canceling the request for proposals.

Initially, the Department stated that the cancellation allowed the new executives to assess the procurement design following the departure of Cabinet Secretary David Scrase and Medicaid Director Nicole Comeaux.

Later, the Governor’s communications director mentioned shared concerns with Scrase and Armijo regarding providers’ ability to ensure seamless care during the transition.

According to gubernatorial spokeswoman Maddy Hayden, the decision to cancel the procurement and reissue it was based solely on safeguarding the interests of Medicaid’s beneficiaries.

In December, a committee evaluated and scored the five proposals received by the Department following the issuance of a request three months prior. In January, Charles Canada, the department’s procurement manager, recommended awarding contracts to four of the five bidders, a suggestion endorsed by Comeaux and Gary Chavez, the department’s chief procurement officer.

Western Sky Community Care, the only existing Medicaid provider, failed to secure a contract. According to documents obtained via a public records request, the health insurance companies recommended for contract awards garnered the highest scores in the evaluation. They offered proposals deemed “most advantageous” to the State.


15 thoughts on “NM Ethics Commission delivers governor a ‘stunning defeat’”

    1. Something similar happened to me a few years ago when I had United Health Care for my MCO. The state automatically switches you to another one (mine was Presbyterian) and I was sent a letter. If you don’t like who they switch you to, you can choose another one. They don’t want you to go without services.

  1. I don’t care if and you don’t post my name and email.. she is the problem as well as the providers suckling the patients life and the help that provided to them and this Governor is helping them steal the public programs by now granting them straight into their pockets!! Hell No !!!!!!!

      1. Vote for a Jezebelian witch who sends young women to the satanic temple to get abortions or continues to have the border open for drug and human sex trafficking of women and children and for the children to be trafficked for pedophiles, Adrinachrome, organ harvesting, human sacrifice, drinking their blood and canabolism? The gov. who shut down Synagogues and Church’s during Covid which was an ESSENTIAL to help people get through the scamdemick while pushing for a drug shot that she violated the Nuremburg Code or not to mention her inappropriate behavior towards a male staffer getting sued for as well as what she did to our Economy but yet she herself could go and do whatever she damn well pleased among other things to long to list? HELL NO!!!!

        1. Spit on! This demonic, greedy, arrogant, and vicious ‘Wicca Witch, Michelle Lujan Grisham, needs to be IMPEACHED then INCARCERATED for her sinister crimes against the Christian Citizens of New Mexico!

  2. Grishams next move will be to eliminate the Ethics board as unnecassary and obstructive,investigate her ties to western skies!

  3. I would like to know where my stimules check that she promised to send im low income and on disibilty havent seen that was it just another lie

    1. This state is so politically corrupt that nothing can be believed. It’s all smoke and mirrors to the benefit of the select few. How this state has voted for so many unethical lying politicians (both sides) is stunning.
      The insurance scam is yet another layer of deceit.

    2. I am on disability and lie income too. I didn’t get my stimulus check either. Maybe because I am a legal U.S. Citizen?

      1. I know that if you change your address or account # for the taxes from 2021 to now your stimulus should have gone to your previous address. That is what happened to my mom. She had to change her banking info since my dad passed away in 2022. Her stimulus was send to her joint account she had with him. She disputed it and got her money as for of a check. Hope it helps.

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