This [act] may be cited as the “Medicaid False Claims Act” . History: Laws 2004, ch. 49, § 1. ANNOTATIONSANNOTATIONS Bracketed material. — The bracketed material was added by the compiler and is not a part of the law. Cross references. — For the Medicaid Fraud Act, see Chapter 30, Article 44 NMSA 1978. Effective […]
A. A court shall not have jurisdiction of an action brought pursuant to the Medicaid False Claims Act against a department official if the action is substantially based on evidence or information known to the department when the action was brought. B. A person shall not bring an action pursuant to the Medicaid False Claims […]
The department shall not be liable for expenses that a person incurs in bringing an action pursuant to the Medicaid False Claims Act. History: Laws 2004, ch. 49, § 11. ANNOTATIONS Effective dates. — Laws 2004, ch. 49 contained no effective date provision, but, pursuant to N.M. Const., art. IV, § 23, was effective May […]
Any employee who is discharged, demoted, suspended, threatened, harassed or otherwise discriminated against in the terms and conditions of employment by the employer because of lawful acts done by the employee on behalf of the employee or others in disclosing information to the department or in furthering a false claims action pursuant to the Medicaid […]
A. A civil action shall be brought within the limitations set forth in Section 37-1-4 NMSA 1978. B. In any action brought pursuant to the Medicaid False Claims Act, the department or the person bringing the action shall be required to prove all essential elements of the cause of action, including damages, by a preponderance […]
The application of a civil remedy pursuant to this law does not preclude the application of other laws, statutes or regulatory remedy, except that a person may not be liable for a civil remedy pursuant to the Medicaid False Claims Act and civil damages or recovery pursuant to the Medicaid Fraud Act [30-44-1 NMSA 1978] […]
A. Damages collected pursuant to the Medicaid False Claims Act on behalf of the state shall be remitted to the state treasurer for deposit in the general fund to be used for the state’s medicaid program. B. Penalties, legal fees or costs of investigation recovered pursuant to the Medicaid False Claims Act on behalf of […]
The purpose of the Medicaid False Claims Act is to deter persons from causing or assisting to cause the state to pay medicaid claims that are false and to provide remedies for obtaining treble damages and civil recoveries for the state when money is obtained from the state by reason of a false claim. History: […]
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 […]
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 […]
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 […]
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. […]
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 […]
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 […]
A. If the department proceeds with an action brought by a person pursuant to the Medicaid False Claims Act, the person shall, subject to the limitations in this subsection, receive at least fifteen percent but not more than twenty-five percent of the proceeds of the action or settlement of the claim, depending upon the extent […]
