{"data":{"id":"us-nm/27-11-12","jurisdiction":"us-nm","citation":"27-11-12","heading":"Rights of medicaid provider or subcontractor; preliminary or final determination of overpayment.","body":"A. A medicaid provider or subcontractor may challenge:\n(1) the department's preliminary or final determination of overpayment as:\n(a) exceeding statutory authority;\n(b) arbitrary or capricious;\n(c) a failure to follow department procedure; or\n(d) not supported by substantial evidence;\n(2) the credentials of persons who participated in the audit or claims review; or\n(3) the methodology or accuracy of the department's audit.\nB. 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.","path":["Chapter 27 - Public Assistance","ARTICLE 11 Medicaid Providers"],"source_url":"https://nmonesource.com/nmos/nmsa-unanno/en/item/18527/index.do","current_through":"2026-07-01","vintage":"","retrieved_at":"2026-09-03T15:02:19Z","sha256":"53e28d5bc085ce028025ed3f7435f748e9f7827398629cc88bd908fa6f99a067","source_id":"us-nm","stale":false,"prev":"us-nm/27-11-11","next":"us-nm/27-11-13"},"notice":"GroundRules: Original legal text. Not legal advice."}