New Mexico Statutes
Article 11 - Medicaid Providers
Section 27-11-8 - Informal conference; corrective action; requirements.

A. A medicaid provider or subcontractor seeking an informal conference pursuant to this section shall serve the department with a written request for such conference no later than thirty calendar days following the service of a preliminary determination of overpayment by the department on the medicaid provider or subcontractor. Upon receipt of a request for an informal conference, the department shall set a date for the conference to occur no later than fourteen business days following receipt of the request.
B. Within seven days following the informal conference, a medicaid provider or subcontractor may submit a proposed corrective action plan to the department to correct clerical, typographical, scrivener's and computer errors or to provide requested credentialing, licensure or training records identified in audit findings. The department shall not unreasonably withhold approval of the proposed corrective action plan. A medicaid provider or subcontractor shall have no less than thirty days from the date of approval of its corrective action plan to provide additional information or documentation to the department to attempt to address or resolve a disputed preliminary finding of overpayment.
History: Laws 2019, ch. 215, § 6.
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

New Mexico Statutes

Chapter 27 - Public Assistance

Article 11 - Medicaid Providers

Section 27-11-1 - Short title.

Section 27-11-2 - Definitions.

Section 27-11-3 - Review of medicaid provider or managed care organization; contract remedies; penalties.

Section 27-11-4 - Retention and production of records.

Section 27-11-5 - Rules.

Section 27-11-6 - Repealed.

Section 27-11-7 - Determination of overpayments or credible allegation of fraud; audit findings; sampling; extrapolation limited; notice of right to informal conference and expedited adjudicatory proceeding.

Section 27-11-8 - Informal conference; corrective action; requirements.

Section 27-11-9 - Expedited adjudicatory proceedings; requirements.

Section 27-11-10 - Qualifications and selection of hearing officer for expedited adjudicatory proceedings.

Section 27-11-11 - Costs of expedited adjudicatory proceeding.

Section 27-11-12 - Rights of medicaid provider or subcontractor; preliminary or final determination of overpayment.

Section 27-11-13 - Release of suspended payment for services previously rendered; prepayment review; remedial training and education; temporary assistance.

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.