New Mexico Code § 27-2-12.7

Medicaid; health care authority employees; standards of conduct; enforcement
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A. As used in this section:
(1) "business" means a corporation, partnership, sole proprietorship, firm, organization or individual carrying on a business;
(2) "authority" or "department" means the health care authority;
(3) "employee" means a person who has been appointed to or hired for an authority office connected with the administration of medicaid funds and who receives compensation in the form of salary;
(4) "employee with responsibility" means an employee who is directly involved in or has a significant part in the medicaid decision-making, regulatory, procurement or contracting process; and
(5) "financial interest" means an interest held by a person, the person's spouse or minor child that is:
(a) an ownership interest in business; or
(b) an employment or prospective employment for which negotiations have already begun.
B. No employee with responsibility shall, for twenty-four months following the date on which the employee ceases to be an employee, act as agent or attorney for another person or business in connection with a judicial or administrative proceeding, application, ruling, contract, claim or other matter relating to the medicaid program with respect to which the employee made an investigation, rendered a ruling or was otherwise substantially and directly involved during the last year the employee was an employee and that was actually pending under the employee's responsibility within that period.
C. The secretary, income support division director or medical assistance division director or their deputies shall not, for twelve months following the date on which that person ceases to be an employee, participate with respect to a judicial or administrative proceeding, application, ruling, contract, claim or other matter relating to the medicaid program and pending before the authority.
D. An employee with responsibility shall not participate in any manner with respect to a judicial or administrative proceeding, application, ruling, contract, claim or other matter relating to the medicaid program and involving the employee's spouse, minor child or a business in which the employee has a financial interest unless prior to the participation:
(1) full disclosure of the employee's relationship or financial interest is made in writing to the secretary; and
(2) a written determination is made by the secretary that the disclosed relationship or financial interest is too remote or inconsequential to affect the integrity of the services of the employee.
E. Violation of any of the provisions of this section by an employee is grounds for dismissal, demotion or suspension. A former employee who violates a provision of this section is subject to assessment by the authority of a civil money penalty of two hundred fifty dollars ($250) for each violation. The authority shall promulgate rules to provide for an administrative appeal of an assessment imposed.
History: Laws 1980, ch. 86, § 1; 1978 Comp., § 10-16-16, recompiled as 1978 Comp., § 27-2-12.7 by Laws 1997, ch. 112, § 10; 2024, ch. 39, § 70.
Cross references. — For state assistance to individuals eligible for medicaid, see 27-2-16 NMSA 1978.
Recompilations. — Laws 1997, ch. 112, § 10 recompiled former 10-16-16 NMSA 1978, relating to medicaid and department of human services employees, as 27-2-12.7 NMSA 1978, effective June 20, 1997.
The 2024 amendment, effective July 1, 2024, substituted the human services department with health care authority in enforcing standards of conduct for employees administering medicaid funds; substituted each occurrence of "human services department" or "department" with "health care authority" or "authority" throughout the section; and in Subsection C, after "director or medical assistance" deleted "bureau chief" and added "division director".

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