HCA’s New Turquoise Claims Continues Rejecting Legitimate Budget Claims of Developmentally Disabled Participants
“The project has seen substantial delays—with the completion date pushed back seven years to the end of FY26, alongside project overruns. HCA will close the project June 2026.” – New Mexico Legislative Finance Committee Report.
If you are someone counting on services for Developmentally Disabled New Mexicans, and were listening to the hype coming from the state’s Health Care Authority leadership over the last several years about the promised new Medicaid Management Information System Replacement (MMISR), it is hard to believe they were talking about a key component of the newly implemented system – the Turquoise Claims component.
As The Candle reported last month, at the June “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).”
Weeks later, the problems continue – despite promises and some modest adjustments by the Health Care Authority.
Turquoise Claims, developed and managed by HCA’s Information Technology (IT) management team and longtime outside contractors, continues to kick out legitimate Waiver claims not accepting or having landing spots in the system for important medical and other eligibility information needed to verify a client’s approval for care expenses.
As some have warned, providers are having difficulty in entering proper information into the new system for Waiver participant care that has already been approved.
Advocates and other stakeholders are concerned that if providers continue to have these problem they won’t be able to provide services until the systemic problems are fixed by HCA and its IT contractors.
The Turquoise Claims system is a major IT project, that HCA and its predecessor agency the Human Services Department (HSD), have promised to develop since 2013.
The MMISR Project, of Which Turquoise Claims is a Component of, Has a Not So Impressive History.
The subject of multiple legislative investigative reviews, going back more than a decade, the MMIS replacement efforts of both the Martinez Administration (2013-2018) and the Lujan Grisham Administration (2019 through 2026) have been disappointing and very costly.
More recently,the New Mexico Legislative Finance Committee included the following comments in its Fiscal Year 2026, 3rd Quarter Report Card on the State’s Information Technology projects, regarding the replacement system for Medicaid services,
“HCA’s Medicaid management information system replacement (MMISR) project ($427.6 million appropriated; 90.2 percent expended), which started in December 2013, will replace the legacy MMIS application and is supported by a 90 percent federal funding match, at a total estimated cost of $534 million in nonrecurring funds alone. The project has seen substantial delays—with the completion date pushed back seven years to the end of FY26, alongside project overruns. HCA will close the project June 2026.”
Despite HSD announcements about the efforts to get the project out of the ditch it was in for years, since the March 2026 roll out of the Turquoise Claims system things have not gone very well for many of those served in the Developmentally Disabled Waiver Programs.
Some Related History: Governor Lujan Grisham Makes Major Leadership Changes at HSD
In late January of 2023, HSD stated in a press release that “New Mexico Medicaid Program Director Nicole Comeaux J.D. MPH, will depart HSD after serving as the Director of the Medical Assistance Division since January 2019.”
A few days later, on January 27, 2026, Governor Michelle Lujan Grisham announced in a press release, “the retirement of Dr. David Scrase from state government. Scrase has served as secretary of the Human Services Department since the governor took office in 2019 and served as Acting Secretary of the Department of Health between 2021 and 2022.“
Scrase was highly respected as a Cabinet leader by many who worked with him.
The Governor’s press release also stated that, “HSD Deputy Secretary Kari Armijo will serve as interim leader of the department.”
Armijo Engages with Conduent for New Medicaid Management Information System
Shortly after Armijo took over as the “interim leader” of HSD, the department entered into a contract with Conduent Incorporated to develop and operate a new Medicaid Management Information System (MMIS) platform to replace the HSD system.
On February 14, 2023, Conduent issued a press release about the new venture, writing that, “The all-encompassing replacement project includes the following services:
- Data Exchange and Reporting Services
- Enterprise Claims Processing (including medical claims, pharmacy claims, non-medical claims, and other payment types)
- Self-Directed Home and Community Based Services
- Pharmacy Benefit Management Services
- Drug Rebate Management Services
Armijo was quoted in the Conduent press release,
““Conduent brings the expertise and solutions that will help position the Human Services Department for the future. By automating manual processes and promoting interoperability between IT systems, operations will become more efficient and effective. We anticipate that the project will also bring significant improvements to help our Medicaid providers by creating a single point of entry for all claims and a streamlined billing process. These and other updates will make it easier for NMHSD and its sister agencies to capture data necessary for measuring and improving health outcomes for our customers,” said Kari Armijo, Acting Secretary, New Mexico Human Services Department.”
Other companies were also involved with the HSD/HCA IT team led by the agency’s Chief Information Officer, in the development and rolling out of the various components of the MMIS replacement project.
Armijo Promoted by Lujan Grisham Formally as Secretary of HSD in October 2023.
In late 2023 and early 2024, shortly after the Governor appointed her formally as the new Secretary for the HSD, Kari Armijo, announced a series of agency senior leadership changes.
Armijo appointed Paula Morgan as the Chief Information Officer and Information Technology Division (ITD) Director. Morgan had been the HSD acting Chief Information Officer (CIO) for nearly a year.
A November 15, 2023, press release from HSD, made clear that Morgan was to “lead technological advancements at Human Services Department.“
Armijo was quoted in the press release, stating,
“HSD is fortunate to have an experienced and capable director to lead our information technology initiatives at the Human Services Department … Paula Morgan is driven by innovation, passion and determination to serve the people of New Mexico and we are fortunate to have her as a leader at HSD.”
A few months later, Armijo made another executive leadership change that was supposed to positively impact the roll out of a number of improved initiatives, including the MMISR component that was to be eventually named Turquoise Claims.
In another HSD press release, dated February 26, 2024, Armijo stated,
“I am thrilled to welcome Dana Flannery as the new Medicaid Director. Dana brings to the table her extensive expertise and innovative vision in public health, which are crucial for advancing our mission and goals … I look forward to working closely with Dana in her new capacity and am excited to see the innovations and advancements she will bring to our Medicaid program.”
Interestingly, Flannery had already been working for the HSD as a Medicaid consultant for just about a year – something Armijo never mentioned.
In three personal service contracts between the winter of 2023 and early 2024, Flannery was paid about $178,880, just prior to her being appointed to be the new Medicaid Director – for which Governor Michelle Lujan Grisham and Armijo increased Flannery’s starting salary to $210,000 a year, an increase of almost $80,000 a year over what had been paid to Flannery’s predecessor.
More reporting on failed efforts and hundreds of millions of dollars of investment in IT contracts and lavish pay raises to senior officials involved in the MMIS replacement project to come later this month.