A. The hearing officer presiding over the expedited adjudicatory proceeding held pursuant to the Medicaid Provider and Managed Care Act shall:
(1) be licensed and in good standing to practice law in New Mexico or another state;
(2) have at least three years' cumulative experience in one or more of the following areas: the health insurance industry, the medicaid program, health care regulatory compliance, medical claims administration or health law;
(3) not currently be employed by or represent, or belong to a law firm that currently represents, the department or a medicaid provider or managed care organization or third-party administrator currently doing business with the department; and
(4) not be related within the third degree of consanguinity to a person currently employed by the department, currently doing business with the department or currently employed by an organization doing business with the department.
B. The hearing officer shall not be:
(1) a lobbyist registered under the Lobbyist Regulation Act [Chapter 2, Article 11 NMSA 1978] who currently represents, or has in the prior calendar year represented, a client in matters before the department; or
(2) affiliated with, or the spouse of, a lobbyist registered under the Lobbyist Regulation Act who currently represents, or has in the prior calendar year represented, a client in matters before the department.
C. The chief hearing officer of the administrative hearings office shall select the hearing officer to preside over an expedited adjudicatory proceeding held pursuant to the Medicaid Provider and Managed Care Act and the Administrative Procedures Act [12-8-1 to 12-8-25 NMSA 1978].
History: Laws 2019, ch. 215, § 8.
Effective 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.
Structure New Mexico Statutes
Chapter 27 - Public Assistance
Article 11 - Medicaid Providers
Section 27-11-1 - Short title.
Section 27-11-2 - Definitions.
Section 27-11-4 - Retention and production of records.
Section 27-11-8 - Informal conference; corrective action; requirements.
Section 27-11-9 - Expedited adjudicatory proceedings; requirements.
Section 27-11-11 - Costs of expedited adjudicatory proceeding.
Section 27-11-14 - Maintenance of services; payment for ongoing services.
Section 27-11-15 - Disposition of recovered medicaid funds.
Section 27-11-16 - Credible allegation of fraud; judicial review; substantial evidence required.
Section 27-11-17 - Award of costs, fees and interest.
Section 27-11-18 - Applicability of Administrative Procedures Act.