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Section 27-12-1 to 27-12-7 – Repealed.
ANNOTATIONS Repeals. — Laws 1998, ch. 52, § 9 repealed 27-12-1 to 27-12-7 NMSA 1978, the Child Health Act, as enacted by Laws 1998, ch. 52, §§ 1 to 7, effective July 1, 2002. For provisions of former sections, see the 1999 NMSA 1978 on NMOneSource.com.
Section 27-13-1 – Short title.
This act [27-13-1 to 27-13-6 NMSA 1978] may be cited as the “Consumer Direction Act”. History: Laws 2003, ch. 210, § 1. ANNOTATIONS Effective dates. — Laws 2003, ch. 210, § 7 made the act effective July 1, 2003.
Section 27-13-2 – Purpose.
The purpose of the Consumer Direction Act is to ensure a consumer the right to direct his personal assistance services if he so chooses by selecting an attendant appropriate to his needs and to maximize personal assistance service availability and satisfaction. History: Laws 2003, ch. 210, § 2. ANNOTATIONS Effective dates. — Laws 2003, ch. […]
Section 27-13-3 – Definitions.
As used in the Consumer Direction Act: A. “attendant” means a person, including an allowable family member, who provides personal assistance services; B. “consumer” means a person receiving personal assistance services through any personal assistance programs offered by the state of New Mexico; C. “department” means any department or agency of the state offering personal […]
Section 27-13-4 – Consumer direction programs authorized.
Consistent with the federal Social Security Act and subject to the appropriation and availability of federal and state funds, each administering department or agency shall by rule provide a program permitting a consumer or surrogate to direct personal assistance services through the hiring, supervision and training of an attendant or attendants paid through a fiscal […]
Section 27-13-5 – Department duties.
A department shall: A. establish by rule the criteria and procedures for developing and amending a personal assistance services plan with a consumer; B. develop criteria and procedures for selection of a fiscal intermediary to contract with the department to provide fiscal intermediary services to a consumer; and C. establish rates for reimbursement of an […]
Section 27-11-15 – Disposition of recovered medicaid funds.
A. Overpayments collected pursuant to the Medicaid Provider and Managed Care Act on behalf of the state shall be remitted to the department for deposit in the general fund to be used for the state’s medicaid program. B. The department shall not enter into a contract to pay any portion of funds recovered by the […]
Section 27-11-16 – Credible allegation of fraud; judicial review; substantial evidence required.
A. A credible allegation of fraud determination by the department shall be deemed a final agency decision and may be appealed pursuant to Section 39-3-1.1 NMSA 1978. B. A medicaid provider or subcontractor that is the subject of a referral to the attorney general for further investigation based on a credible allegation of fraud may […]