New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 351 - SANCTIONS OR REMEDIES
Part 2 - SANCTIONS AND REMEDIES
Section 8.351.2.12 - IMPOSITION OF SANCTIONS
Current through Register Vol. 35, No. 18, September 24, 2024
A. Mandatory sanctions: MAD must impose sanctions when a provider receives a formal reprimand or censure for unethical practice by a professional association of the provider's peers or when a provider is suspended or terminated from participation in medicare or any federal or state-funded health care program. Imposition of sanctions are applied to any provider or other entity receiving payment for services either directly through MAD, its contractor, or through any HSD contracted MCO, subcontractor, or provider.
B. Permissive sanctions: MAD can impose monetary or non-monetary sanctions against a provider or other entity for fraud or other forms of misconduct.
C. Criteria used in assessment of permissive sanctions: MAD uses the following criteria to determine the type of permissive or mandatory sanction to impose: