New Mexico Statutes 30-40-6. Failure to reimburse the human services department [health care authority department] upon receipt of third party payment
A. Failure to reimburse the human services department [health care authority department] upon receipt of third party payment consists of knowing failure by a medicaid provider to reimburse the human services department [health care authority department] or the department’s fiscal agent the amount of payment received from the department for services when the provider receives payment for the same services from a third party.
Attorney's Note
Under the New Mexico Statutes, punishments for crimes depend on the classification. In the case of this section:| Class | Prison | Fine |
|---|---|---|
| second degree felony | up to 9 years | up to $10,000 |
| third degree felony | up to 3 years | up to $5,000 |
| fourth degree felony | up to 18 months | up to $5,000 |
| petty misdemeanor | up to 6 months | up to $500 |
B. A medicaid provider who commits failure to reimburse the human services department [health care authority department] upon receipt of third party payment when the value of the payment made by the department is two hundred fifty dollars ($250) or less is guilty of a petty misdemeanor.
C. A medicaid provider who commits failure to reimburse the human services department [health care authority department] upon receipt of third party payment when the value of the payment made by the department is more than two hundred fifty dollars ($250) but not more than five hundred dollars ($500) is guilty of a misdemeanor.
D. A medicaid provider who commits failure to reimburse the human services department [health care authority department] upon receipt of third party payment when the value of the payment made by the department is more than five hundred dollars ($500) but not more than two thousand five hundred dollars ($2,500) is guilty of a fourth degree felony.
E. A medicaid provider who commits failure to reimburse the human services department [health care authority department] upon receipt of third party payment when the value of the payment made by the department is more than two thousand five hundred dollars ($2,500) but not more than twenty thousand dollars ($20,000) is guilty of a third degree felony.
F. A medicaid provider who commits failure to reimburse the human services department [health care authority department] upon receipt of third party payment when the value of the payment made by the department exceeds twenty thousand dollars ($20,000) is guilty of a second degree felony.