Chapter 30, Article 44 NMSA 1978 may be cited as the “Medicaid Fraud Act”. History: Laws 1989, ch. 286, § 1; 1997, ch. 98, § 1. ANNOTATIONS Cross references. — For provisions relating to medicaid, see 27-2-12 NMSA 1978 et seq. The 1997 amendment, effective June 20, 1997, substituted “Chapter 30, Article 44 NMSA 1978” […]
As used in the Medicaid Fraud Act: A. “benefit” means money, treatment, services, goods or anything of value authorized under the program; B. “claim” means any communication, whether oral, written, electronic or magnetic, that identifies a treatment, good or service as reimbursable under the program; C. “cost document” means any cost report or similar document […]
A. The attorney general, the district attorneys, the unit and the department have the power and authority to investigate violations of the Medicaid Fraud Act and bring actions to enforce the civil remedies established in the Medicaid Fraud Act. B. The attorney general, the district attorneys and those attorneys who are employees of the unit […]
A. Falsification of documents consists of: (1) knowingly making or causing to be made a misrepresentation of a material fact required to be furnished under the program or knowingly failing or causing the failure to include a material fact required to be furnished under the program in any record required to be retained in connection […]
A. Whoever receives payment for treatment, services or goods under the program shall retain all medical and business records relating to: (1) the treatment or care of any recipient; (2) services or goods provided to any recipient; (3) rates paid by the department under the program on behalf of any recipient; and (4) any records […]
A. Obstruction of investigation consists of: (1) knowingly providing false information to, or knowingly withholding information from, any person authorized under the Medicaid Fraud Act to investigate violations of that act or to enforce the criminal or civil remedies of that act where that information is material to the investigation or enforcement; or (2) knowingly […]
A. Medicaid fraud consists of: (1) paying, soliciting, offering or receiving: (a) a kickback or bribe in connection with the furnishing of treatment, services or goods for which payment is or may be made in whole or in part under the program, including an offer or promise to, or a solicitation or acceptance by, a […]
A. Any person who receives payment for furnishing treatment, services or goods under the program, which payment the person is not entitled to receive by reason of a violation of the Medicaid Fraud Act, shall, in addition to any other penalties or amounts provided by law, be liable for: (1) payment of interest on the […]
