N.M. Stat. § 27-11-12

Current through 2024, ch. 69
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.

NMS § 27-11-12

Added by 2019, c. 215,s. 10, eff. 1/1/2020.