New Mexico · Through 2026-07-01

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.
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.

Where this section sits in the code

Chapter 30 - Criminal Offenses
ARTICLE 40 Public Assistance

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.

Collected 2026-09-03T15:02:19Z. Source file · JSON

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