2021 New Mexico Statutes
Chapter 27 - Public Assistance
Article 11 - Medicaid Providers
Section 27-11-12 - Rights of medicaid provider or subcontractor; preliminary or final determination of overpayment.
A. A medicaid provider or subcontractor may challenge:
(1) the department's preliminary or final determination of overpayment as:
(a) exceeding statutory authority;
(b) arbitrary or capricious;
(c) a failure to follow department procedure; or
(d) not supported by substantial evidence;
(2) the credentials of persons who participated in the audit or claims review; or
(3) the methodology or accuracy of the department's audit.
B. A medicaid provider or subcontractor may, but shall not be required to, conduct its own audit or sampling to challenge a preliminary or final determination of overpayment.
History: Laws 2019, ch. 215, § 10.
ANNOTATIONSEffective dates. — Laws 2019, ch. 215, § 20 made Laws 2019, ch. 215 effective January 1, 2020.
Severability. — Laws 2019, ch. 215, § 19, provided that if any part or application of this act is held invalid, the remainder or its application to other situations or persons shall not be affected.
