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Rights of medicaid provider or subcontractor; preliminary or final determination of overpayment

NMSA 1978, § 27-11-12
in effect
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27-11-12. Rights of medicaid provider or subcontractor; preliminary or final determination of overpayment 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. Laws 2019, ch. 215, § 10.
Source: New Mexico Compilation Commission (nmonesource.com)URL: https://nmonesource.com/nmos/nmsa-unanno/en/item/18527/index.do#!b/27-11-12Fetched: 10/20/2026

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