Fiscal impact reports (FIRs) are prepared by the Legislative Finance Committee (LFC) for standing finance committees of the NM Legislature. The LFC does not assume responsibility for the accuracy of these reports if they are used for other purposes.

 

Current FIRs (in HTML & Adobe PDF formats) are available on the NM Legislative Website (legis.state.nm.us).  Adobe PDF versions include all attachments, whereas HTML versions may not.  Previously issued FIRs and attachments may be obtained from the LFC in Suite 101 of the State Capitol Building North.

 

 

F I S C A L    I M P A C T    R E P O R T

 

 

 

SPONSOR

HJC

DATE TYPED

02-18-04

HB

468/HJCS

 

SHORT TITLE

Medicaid False Claims Act

SB

 

 

 

ANALYST

Bransford

 

 

REVENUE

 

Estimated Revenue

Subsequent

Years Impact

Recurring

or Non-Rec

Fund

Affected

FY04

FY05

 

 

 

 

Indeterminate

 

Recurring

General Fund

(Parenthesis ( ) Indicate Revenue Decreases)

 

Relates to SB 461

 

SOURCES OF INFORMATION

LFC Files

 

Responses Received From

Human Services Department (HSD)

Attorney General (AG)

 

SUMMARY

 

Synopsis of Bill

 

The House Judiciary Committee Substitute for House Bill 468 enacts a new section of law, the Medicaid False Claims Act.  The purpose of the Act is to deter persons from knowingly causing or assisting to cause the state to pay Medicaid claims that are false and to provide remedies for obtaining treble damages and civil penalties.

 

The legislation requires HSD to notify the AG prior to filing a civil action and cannot proceed with the action except with the written approval of the AG.  The AG must respond to such requests within twenty working days.  In addition, it requires HSD to obtain the AG’s written consent before proceeding with an action to dismiss or settle the claim.  Pursuant to Subsection C of Section 30-44-8 NMSA 1978, the AG may claim penalties recovered.

 

 

 

Significant Issues

 

The Attorney General points out that presently any individual seeking to pursue a private party “qui tam” may pursue such a course of action through the U.S. Attorney’s Office and the federal court system.  Federal law requires state Medicaid money recovered by such action is to be returned to the state.

 

FISCAL IMPLICATIONS

 

HSD does not have an estimate on how much money Medicaid could recover under the legislation, but assumes the amount will be substantial.

 

ADMINISTRATIVE IMPLICATIONS

 

HSD and the AG will need to establish procedures for the AG to claim penalties recovered pursuant to the Act.

 

RELATIONSHIP

 

Senate Bill 461 is related to House Judiciary Committee Substitute for House Bill 468.

 

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