New Mexico Statutes

§ 27-11-16 — Credible allegation of fraud; judicial review; substantial

New Mexico·Ch. 27 Public Assistance·Art. 11 Medicaid Providers

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 seek judicial review, pursuant to Section 39-3-1.1 NMSA 1978, of the department's determination that the allegation of fraud is credible. The department shall show by substantial evidence that:

(1)it has followed its own procedures; and (2) the evidence relied upon to make its credible allegation of fraud determination was relevant, credible and material to the issue of fraud. C. In a proceeding for judicial review under this section, the rev

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Legislative History

Laws 2019, ch. 215, § 14.

Nearby Sections

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