Bill > SB138

This bill makes several changes to the Medicaid False Claims Act in New Mexico: It expands the definition of a "claim" under the Act to include any request or demand for money or property that is presented to the state or a contractor/grantee where the state has provided or will reimburse any portion of the money or property. It also broadens the types of prohibited conduct that can lead to liability, including making false statements material to an obligation to pay or transmit money to the government. The bill gives both the Human Services Department and the Attorney General the authority to investigate suspected violations and bring civil actions under the Act. It also allows for qui tam (whistleblower) lawsuits to be brought on behalf of the state, with the state having the primary responsibility for prosecuting the action if it intervenes. The bill sets forth procedures and limitations on qui tam actions, such as rules for dismissal/settlement, discovery, and the relator's participation. The bill provides for awards to relators, with a range of 15-25% of the recovery if the state intervenes, or 25-30% if the state declines to intervene. It also includes anti-retaliation provisions to protect whistleblowers. Finally, the bill gives the Attorney General the power to issue civil investigative demands to obtain information relevant to false claims investigations. Overall, the bill aims to strengthen the state's ability to combat Medicaid fraud by expanding the scope of prohibited conduct, enhancing investigation and enforcement tools, and providing greater incentives and protections for whistleblowers.

Health and Social Services

https://www.nmlegis.gov/Legislation/Legislation?chamber=S&legtype=B&legno=138&year=23