New Mexico Statutes 27-2-12.7. Medicaid; health care authority employees; standards of conduct; enforcement
A. As used in this section:
Terms Used In New Mexico Statutes 27-2-12.7
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Contract: A legal written agreement that becomes binding when signed.
- Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
- Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
- Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
(1) “business” means a corporation, partnership, sole proprietorship, firm, organization or individual carrying on a business;
(2) “authority” or “department” means the health care authority;
(3) “employee” means a person who has been appointed to or hired for an authority office connected with the administration of medicaid funds and who receives compensation in the form of salary;
(4) “employee with responsibility” means an employee who is directly involved in or has a significant part in the medicaid decision-making, regulatory, procurement or contracting process; and
(5) “financial interest” means an interest held by a person, the person’s spouse or minor child that is:
(a) an ownership interest in business; or
(b) an employment or prospective employment for which negotiations have already begun.
B. No employee with responsibility shall, for twenty-four months following the date on which the employee ceases to be an employee, act as agent or attorney for another person or business in connection with a judicial or administrative proceeding, application, ruling, contract, claim or other matter relating to the medicaid program with respect to which the employee made an investigation, rendered a ruling or was otherwise substantially and directly involved during the last year the employee was an employee and that was actually pending under the employee’s responsibility within that period.
C. The secretary, income support division director or medical assistance division director or their deputies shall not, for twelve months following the date on which that person ceases to be an employee, participate with respect to a judicial or administrative proceeding, application, ruling, contract, claim or other matter relating to the medicaid program and pending before the authority.
D. An employee with responsibility shall not participate in any manner with respect to a judicial or administrative proceeding, application, ruling, contract, claim or other matter relating to the medicaid program and involving the employee’s spouse, minor child or a business in which the employee has a financial interest unless prior to the participation:
(1) full disclosure of the employee’s relationship or financial interest is made in writing to the secretary; and
(2) a written determination is made by the secretary that the disclosed relationship or financial interest is too remote or inconsequential to affect the integrity of the services of the employee.
E. Violation of any of the provisions of this section by an employee is grounds for dismissal, demotion or suspension. A former employee who violates a provision of this section is subject to assessment by the authority of a civil money penalty of two hundred fifty dollars ($250) for each violation. The authority shall promulgate rules to provide for an administrative appeal of an assessment imposed.