N.M. Stat. » N.M. Stat. / Chapter 27 / Article 14
New Mexico Statutes

N.M. Stat. § 27-14-7 (2026)

Civil action for false claims.

✓ current as of May 2026
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    A. The department shall diligently investigate suspected violations. If the
department finds that a person has violated or is violating the provisions of the Medicaid
False Claims Act, the department may bring a civil action pursuant to Subsection F of
this section.

    B. A private civil action may be brought by an affected person for a violation of the
Medicaid False Claims Act on behalf of the person bringing suit and for the state. The
action shall be brought in the name of the state. The action may be dismissed if the
court and the department, pursuant to Subsection F of this section, give written consent
to the dismissal and their reasons for consenting.

    C. For private civil actions, a copy of the complaint and written disclosure of
substantially all material evidence and information the person possesses shall be
served on the department. The complaint shall be filed in writing and shall remain under
seal for at least sixty days. The complaint shall not be served on the defendant until the
expiration of sixty days or any extension approved. Within sixty days after receiving a
copy of the complaint, the department shall conduct an investigation of the factual
allegations and legal contentions made in the complaint, shall make a written
determination of whether there is substantial evidence that a violation has occurred and
shall provide the person against which a complaint has been made with a copy of the
determination. If the department determines that there is not substantial evidence that a
violation has occurred, the complaint shall be dismissed.

   D. The department may, for good cause shown, move the court for extensions of
time during which the complaint remains under seal. Any such motion may be
supported by affidavits or other submissions in camera. The defendant shall not be
required to respond to a complaint filed pursuant to this section until twenty days after
the complaint is unsealed and served to the defendant. The complaint shall be deemed
unsealed at the expiration of the sixty-day period in the absence of a court-approved
extension.

   E. Before the expiration of the sixty-day period or any extensions obtained, the
department, pursuant to Subsection F of this section, shall:

      (1)   proceed with the action, in which case the action shall be conducted by
the department; or

        (2)    notify the court and the person who brought the action that it declines to
take over the action, in which case the person bringing the action shall have the right to
conduct the action if the department determined that there is substantial evidence that a
violation of the Medicaid False Claims Act has occurred.

    F. The department shall notify the attorney general prior to filing a civil action
pursuant to the Medicaid False Claims Act and shall not proceed with the action except
with the written approval of the attorney general. The attorney general shall, within
twenty working days from the notification by the department, notify the department
whether it may proceed with the civil action. Failure by the attorney general to notify the
department of its determination within the specified time period shall be construed as
consent to proceed. The department shall, after filing the civil action, notify the attorney
general of any proposed dismissal or settlement and the department shall not proceed
with the dismissal or settlement except with the written approval of the attorney general.

History: Laws 2004, ch. 49, § 7.

                                     ANNOTATIONS

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.
Notes of Decisions
Cited in 10 cases (6 in the last 5 years), 2011–2025 · leading case: United States ex rel. Wood v. Allergan, Inc., 246 F. Supp. 3d 772 (S.D.N.Y. 2017).
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United States ex rel. Wood v. Allergan, Inc., 246 F. Supp. 3d 772 (S.D.N.Y. 2017). “” N.M. Stat. Ann. § 27-14-7 (E)(2). Delaware law included a similar requirement until 2009.”
State ex rel. Balderas v. Bristol-Myers Squibb, 436 P.3d 724 (N.M. Ct. App. 2018). · cites it 16× “" It is true that Section 27-14-7 requires that, when a claim is supported by substantial evidence, the state must either pursue the claim or permit the relator to pursue it.”
United States ex rel. Streck v. Allergan, Inc., 894 F. Supp. 2d 584 (E.D. Pa. 2012). “6, § 1203(b)(4)(b) (2005); N.M. Stat. § 27-14-7(E)(2) (2007). There is no dispute that neither state provided this written determination.”
United States ex rel. King v. Solvay S.A., 823 F. Supp. 2d 472 (S.D. Tex. 2011). “See N.M. Stat. Ann. § 27-14-7 (B). The Fraud Against Taxpayers Act states that a "person may bring a civil action,” *521 without using the "affected” modifier.”
La Frontera Ctr., Inc. v. United Behavioral Health, Inc. (D.N.M. 2023). · cites it 7× “§ 3730 , New Mexico Medicaid False Claims Act (MFCA), N.M. Stat. Ann. § 27-14-7 , the New Mexico Fraud Against Taxpayers Act (FATA), N.”
La Frontera Ctr., Inc. v. United Behavioral Health, Inc. (D.N.M. 2024). · cites it 6× “§ 3730 , New Mexico Medicaid False Claims Act (MFCA), N.M. Stat. Ann. § 27-14-7 , the New Mexico Fraud Against Taxpayers Act (FATA), N.”
La Frontera Ctr., Inc. v. United Behavioral Health, Inc. (D.N.M. 2025). · cites it 4× “The Court first notes that the HSD letter only addresses N.M. Stat. Ann. § 27-14-7 (C). See Doc. 15.”
Ellis v. Cvs Health Corp. (E.D. Pa. 2023). · cites it 2× “N.M. Stat. § 27-14-7(B). While the statute does not define “affected person[s],” courts in the Third Circuit have stated that the term should not be interpreted “in the narrowest sense as only referring to New Mexico citizens,” further holding that the term encompasses employees…”
La Frontera Ctr., Inc. v. United Behavioral Health, Inc. (D.N.M. 2023). “§ 27-14-7. In contrast, under the NMFATA, the State of New Mexico or a political subdivision, investigates related claims.”
United States of Am. ex rel. Rebecca Miller v. Reckitt Benckiser Grp. PLC, Inc. (W.D. Va. 2023). “N.M. Stat. Ann. § 27-14-7 (C). A motion to dismiss an original complaint is not the appropriate time to resolve this issue under New Mexico law because New Mexico makes its determination after the filing of the complaint.”
— N.M. Stat. § 27-14-7(A) — 1 case
State ex rel. Balderas v. Bristol-Myers Squibb, 436 P.3d 724 (N.M. Ct. App. 2018). “" It is true that Section 27-14-7 requires that, when a claim is supported by substantial evidence, the state must either pursue the claim or permit the relator to pursue it.”
— N.M. Stat. § 27-14-7(B) — 2 cases
State ex rel. Balderas v. Bristol-Myers Squibb, 436 P.3d 724 (N.M. Ct. App. 2018). “" It is true that Section 27-14-7 requires that, when a claim is supported by substantial evidence, the state must either pursue the claim or permit the relator to pursue it.”
Ellis v. Cvs Health Corp. (E.D. Pa. 2023). “N.M. Stat. § 27-14-7(B). While the statute does not define “affected person[s],” courts in the Third Circuit have stated that the term should not be interpreted “in the narrowest sense as only referring to New Mexico citizens,” further holding that the term encompasses employees…”
— N.M. Stat. § 27-14-7(C) — 1 case
State ex rel. Balderas v. Bristol-Myers Squibb, 436 P.3d 724 (N.M. Ct. App. 2018). “" It is true that Section 27-14-7 requires that, when a claim is supported by substantial evidence, the state must either pursue the claim or permit the relator to pursue it.”
— N.M. Stat. § 27-14-7(E) — 1 case
State ex rel. Balderas v. Bristol-Myers Squibb, 436 P.3d 724 (N.M. Ct. App. 2018). “" It is true that Section 27-14-7 requires that, when a claim is supported by substantial evidence, the state must either pursue the claim or permit the relator to pursue it.”
— N.M. Stat. § 27-14-7(E)(2) — 2 cases
United States ex rel. Streck v. Allergan, Inc., 894 F. Supp. 2d 584 (E.D. Pa. 2012). “6, § 1203(b)(4)(b) (2005); N.M. Stat. § 27-14-7(E)(2) (2007). There is no dispute that neither state provided this written determination.”
Ellis v. Cvs Health Corp. (E.D. Pa. 2023). “N.M. Stat. § 27-14-7(B). While the statute does not define “affected person[s],” courts in the Third Circuit have stated that the term should not be interpreted “in the narrowest sense as only referring to New Mexico citizens,” further holding that the term encompasses employees…”
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