DDSD Services in Jeopardy From Sloppy Transition of Turquoise Claims System
Parents and Caregivers of New Mexicans With Intellectual and Developmental Disabilities Sound Alarm Bell, Citing Poor Communication From State Agency, as Services Go Unpaid.
Last week, at the bi-monthly meeting of the Advisory Council on Quality Supports for People with Intellectual/Developmental Disabilities (ACQ) there was a chorus of complaints about the failure of a new billing system introduced by the New Mexico Health Care Authority (HCA).
According to the HCA, the ACQ “advises the New Mexico Health Care Authority on the systems guiding the provision of services and supports that assist people with Intellectual/Developmental Disabilities (IDD) of all ages and their families to be fully included in New Mexico communities.”
ACQ members include clients of Developmentally Disabled Waiver (DD Waiver), parents of clients, caregivers, provider agencies and advocates for DD Waiver clients.
Many of those speaking during the public comment session of the three hour meeting, expressed serious concerns about the negative impact of the failed billing system on the delivery of vital care by direct service professionals and others who provide care giving and support services to clients of the DD Waiver.
They explained that the HCA rolled out a new billing system, known as the Turquoise Medicaid Billing System, on March 23, 2026.
According to those with knowledge of the system, it routinely kicks out legitimate claims and does not accept important medical and other eligibility information needed to verify a client’s approval for care expenses.
Included among the many complaints at the ACQ meeting was the very poor communication regarding the problems, from both the HCA and the contractor (a company named Conduent) that designed and is implementing the system.
Legislative Health and Human Services Committee – “It’s on our Radar.”
Yesterday, members of the New Mexico Legislative Health and Human Services Committee (LHHS) also heard that the new system advanced by the Health Care Authority was wreaking havoc with the ability of the DD Waiver infrastructure as many services were not getting paid due to the new Turquoise Claims system failing to recognize key elements used to determine payment approval.
The DD Waiver community was frustrated and fearful of services being dropped or suspended due to the state not processing important information regarding DD Waiver clients’ individual service plans which impacts making timely payments necessary to pay workers.
At the LHHS meeting yesterday, one person stated that,
“We’ve tried reaching out to both Conduent and the HCA, and we are not getting a lot of communication from them.
“But we are concerned, because a lot of providers are at a point where they may have to stop rendering services to individuals, specifically the Developmentally Disabled Waiver community, which could result in quite a mess, because a lot of these people need quite a lot of care ...”
“… We are just looking for some type of accountability from Medicaid, Conduent, HCA, and a resolution to the system.”
LHHS Chairwoman, Representative Liz Thomson, acknowledged that she also had received, “quite a few emails with concern.”
She also noted, “It’s on our radar.”
During the ACQ meeting last week, the Developmental Disabilities Services Division (DDSD) director, Jennifer Zwally, reported to ACQ members and others attending the meeting (including The Candle) via Zoom, that her team was aware of the problems and had spoken with other HCA officials about the impact on the DD Waiver community.
She read from what appeared to be a very recently prepared statement that things would be addressed by the end of the week and that a memo was to be released later that same day.
The Candle will be reporting more on the HCA responses in updated reporting over the next two days, but we felt it is important to put into perspective how promises of key improvements to the care services systems by the Governor and HCA policymakers from as far back as four years ago, have not been kept.
Years After the Elimination of the “Wait List” and Passage of a Law Restructuring Health Care Agencies, Important Direct Care Has Been Limited or Jeopardized by Poorly Vetted Systems.
Here is a look back at what the headlines and press releases boasted about promised DD Waiver service improvements.
In the Spring of 2022, Governor Michelle Lujan Grisham announced the end of the so-called wait list for services for DD Waiver clients.
But as Representative Thomson stated in May of 2024 at a LHHS meeting, regarding the progress on services for the developmentally disabled, “ … [T]here aren’t services available. You may get a spot on the Waiver, but if there’s no PT [physical therapists – for example] to provide the service, you’re not on the Wait list, but you’re also not getting services. Workforce, once again strikes.”
More recently, there is this exchange between a member of the House Appropriations and Finance Committee, the HCA Secretary, and the DDSD Director, as reported by The Candle in March of 2026, regarding the availability of services for DD Waiver clients in rural areas of New Mexico:
State Representative Harlan Vincent of Ruidoso Downs asked Health Care Authority (HCA) Secretary Kari Armijo if it was true “that there are no willing providers [to] supported living services due to insufficient rates in 15 counties?“
(Supported living services are provided to some of the most vulnerable waiver clients.)
Armijo, a cabinet level manager being paid $241,000/year, responded, “I’m not sure.“
Armijo consulted Jennifer Zwally, the Director of the HCA’s Developmental Disabilities Supports Division (DDSD), who then responded to the Representative’s question: “That is correct.“
Armijo also stated, “I will follow up on that. This is new information to me. I will follow up with Director Zwally, and we will get back to you on what the strategy is.”
Moving the Developmental Disabilities Supports Division and the Division of Health Improvement from the Department of Health to the new Health Care Authority Failed in Delivering Better Service to the DD Waiver Community as Envisioned in SB 16.
On April 7, 2023, when the Governor signed into law Senate Bill 16, Senator Elizabeth “Liz” Stefanics and Representative Elizabeth “Liz” Thomson, probably didn’t envision that three years later the Governor’s executive team would still be bumbling what should have been a reform of the delivery system for many Medicaid related services.
The Governor’s media team provided a press release that day about SB 16 and four other healthcare-related bills, which included comments from the Governor and a description of SB 16’s goals.
“Today is a great day for New Mexico families, patients and providers, and this was some of the greatest progress I have seen on health care during my career,” said Gov. Lujan Grisham. “It’s worth noting that many of these bills passed with bipartisan and often unanimous support for legislation that fixes significant issues with the health care system and strengthens the pieces we know are working.”
Writing more specifically about SB 16, the press release noted about the creation of a new agency to replace the Human Services Department as of July 1, 2024:
“Create Health Care Authority Department, establishes a single unified department responsible for health care purchasing, regulation and policy that provides a foundation for effective management and oversight of heath care. It aligns licensing and oversight with the purchasing of health care services and improves transparency.”
Later that year the Secretary-designate of the Human Services Department, Kari Armijo, released a transition plan for the changes anticipated with SB 16.
The following quotes are from that November 1, 2023, Executive Summary of New Mexico’s Transition Plan for the Health Care Authority (a pdf of the complete document can be found at the end of this article).
“The establishment of the HCA is a significant moment for the State of New Mexico that demonstrates Governor Michelle Lujan Grisham’s commitment to prioritizing the health and well-being of every New Mexican by creating a single agency that will be responsible for health care purchasing, policy, and regulation.”
“The establishment of the HCA is not merely a name change for the Human Services Department, but
a demonstration of the Governor’s commitment to building a healthier New Mexico by ensuring … Transparency and Clarity, Oversight and Accountability, Cost-Effectiveness, Customer Service, and A Unified Approach to Health Care …”
In follow-up reporting, The Candle will explore how people in key positions of policy making for state’s delivery of health care services to the DD Waiver community have focused more on spinning a narrative than on delivering adequate and consistent care.
The next Governor and their team, whoever they may be, should focus on making the system work.