N.M. Stat. § 27-14-4 (2026)

  A person commits an unlawful act and shall be liable to the state for three times the
amount of damages that the state sustains as a result of the act if the person:

  A. presents, or causes to be presented, to the state a claim for payment under the
medicaid program knowing that such claim is false or fraudulent;

   B. presents, or causes to be presented, to the state a claim for payment under the
medicaid program knowing that the person receiving a medicaid benefit or payment is
not authorized or is not eligible for a benefit under the medicaid program;

    C. makes, uses or causes to be made or used a record or statement to obtain a
false or fraudulent claim under the medicaid program paid for or approved by the state
knowing such record or statement is false;

  D. conspires to defraud the state by getting a claim allowed or paid under the
medicaid program knowing that such claim is false or fraudulent;

    E. makes, uses or causes to be made or used a record or statement to conceal,
avoid or decrease an obligation to pay or transmit money or property to the state,
relative to the medicaid program, knowing that such record or statement is false;

   F. knowingly applies for and receives a benefit or payment on behalf of another
person, except pursuant to a lawful assignment of benefits, under the medicaid program
and converts that benefit or payment to his own personal use;

   G. knowingly makes a false statement or misrepresentation of material fact
concerning the conditions or operation of a health care facility in order that the facility
may qualify for certification or recertification required by the medicaid program; or

   H. knowingly makes a claim under the medicaid program for a service or product
that was not provided.

History: Laws 2004, ch. 49, § 4.

                                      ANNOTATIONS

Cross references. — For the Medicaid Fraud Act, see Chapter 30, Article 44 NMSA
1978.

Effective dates. — Laws 2004, ch. 49 contained no effective date provision, but,
pursuant to N.M. Const., art. IV, § 23, was effective May 19, 2004, 90 days after
adjournment of the legislature.