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
also be obtained from the LFC in
|
SPONSOR |
Altamirano |
DATE TYPED |
|
HB |
|
||
|
SHORT
TITLE |
Use of Funds Recovered from Medicaid Fraud |
SB |
213a/SJC |
||||
|
|
ANALYST |
Bransford |
|||||
APPROPRIATION
|
Appropriation
Contained |
Estimated
Additional Impact |
Recurring or
Non-Rec |
Fund Affected |
||
|
FY04 |
FY05 |
FY04 |
FY05 |
||
|
|
|
|
See
Narrative |
Recurring |
OSF |
(Parenthesis
( ) Indicate Expenditure Decreases)
REVENUE
|
Estimated Revenue |
Subsequent Years Impact |
Recurring or
Non-Rec |
Fund Affected |
|
|
FY04 |
FY05 |
|||
|
|
(Unknown) |
|
Recurring |
General
Fund |
(Parenthesis ( ) Indicate Revenue Decreases)
LFC Files
Responses
Received From
Attorney
General (AG)
Human
Services Department (HSD)
SUMMARY
Synopsis of SJC Amendment
The Senate Judiciary Amendment specifies that
the Medicaid Fraud Control Unit may retain up to $250 thousand in FY 04, $125
thousand in FY 05, and $75 thousand in FY 06 from penalties, and the costs of
investigation. All other money collected
shall be remitted to the state treasurer for deposit in the general fund.
Synopsis of Original Bill
Senate Bill 213 amends
Section 30-44-8 NMSA 1978, Medicaid Fraud Act, to allow the Medicaid Fraud
Control Unit to retain penalties, legal fees and costs of investigation and
civil enforcement instead of sending the money collected from penalties to the
general fund.
Significant Issues
The
change to §30-44-8 C was requested by the Medicaid Fraud Division (MFD) of the
Attorney General’s Office. The request
was prompted by a change in U.S. Department of Health and Human Services (DHHS)
- Office of the Inspector General Program policy which permits states to retain
state penalty monies provided the state has appropriate legislation enabling
such retention. According to the AG,
DHHS policy says that a state may retain any penalty recollected pursuant to the State’s Medicaid Fraud Act
and provided that 1) full reimbursement of the Federal overpayment is
made and 2) the state Medicaid Program is reimbursed in
full.
FISCAL IMPLICATIONS
HSD is concerned that if all penalties and costs
go to MFCU rather than to the general fund, it could have significant fiscal
consequences for the general fund. HSD
also has said that if penalties and costs were to continue going into the
general fund or, instead to the Human Services Department, the money could be
appropriated or utilized to help reduce the state’s Medicaid budget.
ADMINISTRATIVE IMPLICATIONS
The AG reports that the ability of the Medicaid
Fraud Division to retain penalty and/or investigation costs is absolutely
necessary for the division to litigate complex white collar crimes and
resident abuse and neglect cases.
Medical and/or financial experts are needed not only to investigate
cases, but also to prosecute complex cases in court. The Medicaid Fraud Division has said they
will only be able to pursue one complex case per year with expert witnesses
without additional funds to contract with more experts.
TECHNICAL ISSUES
HSD is also concerned that if the title of the
bill suggests that the “unit” described in the bill is the Medicaid Fraud Unit
of the Attorney General’s Office (MFCU), it would appear to conflict with other
sections of the Medicaid Fraud Act, including 30-44-2(R) and 30-44-3(A), which
would define “unit” to include any agency that could prosecute or bring civil
suit under the Medicaid Fraud Act, such as a district attorney or the Human
Services Department.
VB/yr:dm