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.

Attorney's Note

Under the New Mexico Statutes, punishments for crimes depend on the classification. In the case of this section:
ClassPrisonFine
second degree felonyup to 9 yearsup to $10,000
third degree felonyup to 3 yearsup to $5,000
fourth degree felonyup to 18 monthsup to $5,000
petty misdemeanorup to 6 monthsup to $500
For details, see N.M. Stat. Ann. § 31-18-15 and N.M. Stat. Ann. § 31-19-1
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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.