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Section 27-11-12 - Rights of medicaid provider or subcontractor; preliminary or final determination of overpayment — New Mexico Law | CourtGPT
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New Mexico Legal Code

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

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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.History: Laws 2019, ch. 215, § 10.ANNOTATIONSEffective 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.