Section 27-15-2 – Definition.
As used in the Money Follows the Person in New Mexico Act, “department” means the aging and long-term services department [9-23-4 NMSA 1978]. History: Laws 2006, ch. 112, § 2. ANNOTATIONS Effective dates. — Laws 2006, ch. 112 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective May […]
Section 27-15-3 – Community-based living; choice of options.
An elderly or disabled individual who is identified and assessed as eligible for community-based living shall be allowed to choose, from among all service options available, the type of service that best meets that individual’s needs. The individual’s medical assistance funds shall be made available for the individual for the service option the individual selects, […]
Section 27-14-3 – Definitions.
As used in the Medicaid False Claims Act: A. “claim” means a written or electronically submitted request for payment of health care services pursuant to the medicaid program; B. “department” means the human services department; C. “medicaid” means the federal-state program administered by the human services department pursuant to Title 19 or Title 21 of […]
Section 27-14-4 – False claims against the state; liability for certain acts.
A person commits an unlawful act and shall be liable to the state for three times the amount of damages that the state sustains as a result of the act if the person: A. presents, or causes to be presented, to the state a claim for payment under the medicaid program knowing that such claim […]
Section 27-14-5 – Documentary material in possession of state agency.
A. The department shall have access to all documentary materials of persons and medicaid recipients to which a state agency has access. Documentary material provided pursuant to this subsection is provided to allow investigation of an alleged unlawful act or for use or potential use in an administrative or judicial proceeding. B. Except for disclosure […]
Section 27-14-6 – Immunity.
Notwithstanding any other law, a person is not civilly or criminally liable for providing access to documentary material pursuant to the Medicaid False Claims Act [27-14-1 NMSA 1978] to a person identified in Subsection B of Section 5 of that act. History: Laws 2004, ch. 49, § 6. ANNOTATIONS Effective dates. — Laws 2004, ch. […]
Section 27-14-7 – Civil action for false claims.
A. The department shall diligently investigate suspected violations. If the department finds that a person has violated or is violating the provisions of the Medicaid False Claims Act, the department may bring a civil action pursuant to Subsection F of this section. B. A private civil action may be brought by an affected person for […]
Section 27-14-8 – Rights of the parties to qui tam actions.
A. If the department proceeds with the action, it shall have the exclusive responsibility for prosecuting the action and shall not be bound by an act of the person bringing the action. The person bringing the action shall have the right to continue as a nominal party to the action and shall not have the […]
Section 27-13-6 – Report.
Annually by October 1, each department shall deliver a report to the legislative finance committee and the legislative health and human services committee on services provided pursuant to the Consumer Direction Act and a comparison of those services and services provided by the department through other means and an evaluation of the effectiveness and consumer […]
Section 27-13-7 – Fiscal intermediary; exemptions; workers’ compensation.
A. A fiscal intermediary shall not be subject to vicarious liability as an employer or principal for a wrongful act committed by a personal care attendant if the attendant: (1) is not a current or former employee of the fiscal intermediary; (2) has not received training or instruction from the fiscal intermediary with respect to […]