New Mexico False Claims Act
New Mexico Whistleblower Laws
New Mexico Insurance Claims Fraud Prevention Act
It is imperative that you speak with a whistleblower law firm about your rights as a New Mexico whistleblower. The statutes listed here may not be up to date or may be enforced differently than written. Also, there are many procedural hurdles to properly file a New Mexico False Claims Act lawsuit, and if you don’t follow them you may lose your case before it even begins.
Highlights of the New Mexico False Claims Act:
New Mexico Whistleblower Awards – Here’s what you can potentially receive as a New Mexico Whistleblower commencing a New Mexico False Claims Act (FCA) lawsuit (awards vary depending on whether the government intervenes or not):
New Mexico False Claims Act Qui Tam Intervened Relator’s Award: 15% to 25% of the state’s Medicaid recovery.
New Mexico False Claims Act Qui Tam Non-Intervened Relator’s Award: 25% to 30% of the state’s Medicaid recovery
Whistleblower awards are based on a variety of factors including but not limited to how useful the whistleblower’s information was, cooperation of the whistleblower and their counsel, and length of time the relator knew about the information and did not blow the whistle.
New Mexico Whistleblower Statutory Penalties – Defendants who violate this statute by committing New Mexico Medicaid fraud or other fraud against the government may be liable for:
Fines ranging from $5,000 to $10,000
Frequent Asked Questions regarding how to blow the whistle in New Mexico:
Q. As a New Mexico whistleblower am I protected from retaliation?
A. Yes, the New Mexico False Claims Act protects employees from employer retaliation as a result of their whistleblowing.
Q. Will my employer find out if I file a New Mexico Qui Tam Action? When?
A. All False Claims Act lawsuits are initially filed under seal so the defendant is unaware that it is being sued. This allows the government time to investigate the case. Often New Mexico Qui Tam actions are filed in conjunction with Federal False Claims Act (FCA) actions and it can take years for the case to be unsealed or for your employer to learn about the action. It is critical not to delay and to consult with a New Mexico Whistleblower law firm as soon as possible.
New Mexico False Claims Act
The New Mexico Fraud Against Taxpayers Act allows whistleblowers to bring suit in the name of the State of New Mexico where a wrongdoer engages in conduct that defrauds the state or local governments of taxpayer dollars. The law is a broad reaching statute designed to address an array of wrongdoing from health care fraud to fraud involving any type of government contract or business relationship involving state or local money.
HOUSE BILL 770
48TH LEGISLATURE – STATE OF NEW MEXICO – FIRST SESSION, 2007
FOR THE COURTS, CORRECTIONS AND JUSTICE COMMITTEE AN ACT
RELATING TO CIVIL ACTIONS; ENACTING THE FRAUD AGAINST TAXPAYERS ACT; CREATING A PRIVATE CIVIL ACTION ON BEHALF OF THE STATE AGAINST A PERSON WHO MAKES A FALSE CLAIM FOR PAYMENT BY THE STATE; PROVIDING FOR A CIVIL ACTION BY A STATE AGENCY; PROVIDING FOR INTERVENTION BY A STATE AGENCY; PROVIDING FOR QUI TAM AWARDS; PROHIBITING RETALIATION BY EMPLOYERS; PROVIDING PENALTIES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:
Section 1. SHORT TITLE.–This act may be cited as the “Fraud Against Taxpayers Act”.
Section 2. DEFINITIONS.–As used in the Fraud Against Taxpayers Act:
- “claim” means a request or demand for money, property or services when all or a portion of the money, property or services requested or demanded issues from or is provided by a state agency;
- “employer” includes an individual, corporation, firm, association, business, partnership, organization, trust and the state and any of its agencies, institutions or political subdivisions;
- “knowingly” means that a person, with respect to information, acts:
(1) with actual knowledge of the truth or falsity of the information;
(2) in deliberate ignorance of the truth or falsity of the information; or
(3) in reckless disregard of the truth or falsity of the information;
- “person” means an individual, corporation, firm, association, organization, trust, business, partnership, limited liability company, joint venture or any legal or commercial entity; and
- “state agency” means the state of New Mexico or any of its branches, agencies, departments, boards, commissions, officers, institutions or instrumentalities, including the New Mexico finance authority, the New Mexico mortgage finance authority and the New Mexico lottery authority, to which a false claim is made.
Section 3. FALSE CLAIMS–LIABILITY–PENALTIES–EXCEPTION.–
- A person shall not:
(1) knowingly present, or cause to be presented, to an employee, officer or agent of the state or to a contractor, grantee or other recipient of state funds a false or fraudulent claim for payment or approval;
(2) knowingly make or use, or cause to be made or used, a false record or statement to obtain approval or payment on a false or fraudulent claim;
(3) conspire to defraud the state by obtaining approval or payment on a false claim;
(4) when in possession, custody or control of property or money used or to be used by the state, knowingly deliver or cause to be delivered less property or money than the amount indicated on a certificate or receipt;
(5) when authorized to make or deliver a document certifying receipt of property used or to be used by the state, knowingly make or deliver a receipt that falsely represents the property used or to be used;
(6) knowingly buy, or receive as a pledge of an obligation or debt, public property from any person that may not lawfully sell or pledge the property;
(7) knowingly make or use, or cause to be made or used, a false record or statement to conceal, avoid or decrease an obligation to pay or transmit money or property to the state; or
(8) as a beneficiary of an inadvertent submission of a false claim and having subsequently discovered the falsity of the claim, fail to disclose the false claim to the state agency within a reasonable time after discovery.
- Proof of specific intent to defraud is not required for a violation of Subsection A of this section. C. A person who violates Subsection A of this section shall be liable for:
(1) three times the amount of damages sustained by a state agency because of the violation;
(2) a civil penalty of not less than five thousand dollars ($5,000) and not more than ten thousand dollars ($10,000) for each violation;
(3) the costs of a civil action brought to recover damages or penalties; and
(4) reasonable attorney fees, including fees for state agency counsel.
- A court may assess two times the amount of damages sustained by a state agency and no civil penalty if the court finds all of the following:
(1) the person committing the violation furnished the state agency with all information known to that person about the violation within thirty days after the date on which the person first obtained the information;
(2) at the time that the person furnished the state agency with information about the violation, a criminal prosecution, civil action or administrative action had not been commenced with respect to the violation, and the person did not have actual knowledge of the existence of an investigation into the violation; and
(3) the person fully cooperated with any investigation by the state agency.
- This section does not apply to claims, records or statements made pursuant to the provisions of Chapter 7 NMSA 1978.
Section 4. INVESTIGATION BY A STATE AGENCY–DELEGATION–CIVIL ACTION.–
- A state agency shall diligently investigate suspected violations of Section 3 of the Fraud Against Taxpayers Act, and if the state agency finds that a person has violated or is violating that section, the state agency may bring a civil action against that person pursuant to the Fraud Against Taxpayers Act.
- A state agency may in appropriate cases delegate the authority to investigate or to bring a civil action to the attorney general, and when this occurs, the attorney general shall have every power conferred upon the state agency pursuant to the Fraud Against Taxpayers Act.
Section 5. CIVIL ACTION BY QUI TAM PLAINTIFF–STATE AGENCY MAY INTERVENE.–
- A person may bring a civil action for a violation of Section 3 of the Fraud Against Taxpayers Act on behalf of the person and the state. The action shall be brought in the name of the state. The person bringing the action shall be referred to as the qui tam plaintiff. Once filed, the action may be dismissed only with the written consent of the court, taking into account the best interest of the parties involved and the public purposes behind the Fraud Against Taxpayers Act.
- A complaint filed by a qui tam plaintiff shall be filed in camera in district court and shall remain under seal for at least sixty days. No service shall be made on a defendant and no response is required from a defendant until the seal has been lifted and the complaint served pursuant to the rules of civil procedure.
- On the same day as the complaint is filed, the qui tam plaintiff shall serve the state agency to which the false claim was made with a copy of the complaint and written disclosure of substantially all material evidence and information the plaintiff possesses. The state agency may intervene and proceed with the action within sixty days after receiving the complaint and the material evidence and information. Upon a showing of good cause and reasonable diligence in the state agency’s investigation, the state agency may move the court for an extension of time during which the complaint shall remain under seal.
- Before the expiration of the sixty-day period or any extensions of time granted by the court, the state agency shall notify the court that it:
(1) intends to intervene and proceed with the action; in which case, the seal shall be lifted and the action shall be conducted by the state agency; or
(2) declines to take over the action; in which case, the seal shall be lifted and the qui tam plaintiff shall proceed with the action.
- When a person brings an action pursuant to this section, no person other than the state agency to which the false claim was made may intervene or bring a related action based on the facts underlying the pending action.
Section 6. RIGHTS OF THE QUI TAM PLAINTIFF AND THE STATE.–
- If a state agency proceeds with the action, the state agency shall have the primary responsibility of prosecuting the action and shall not be bound by an act of the qui tam plaintiff. The qui tam plaintiff shall have the right to continue as a party to the action, subject to the limitations of this section.
- The state agency may seek to dismiss the action for good cause notwithstanding the objections of the qui tam plaintiff if the qui tam plaintiff has been notified of the filing of the motion and the court has provided the qui tam plaintiff with an opportunity to oppose the motion and to present evidence at a hearing.
- The state agency may settle the action with the defendant notwithstanding objections by the qui tam plaintiff if the court determines, after a hearing providing the qui tam plaintiff an opportunity to present evidence, that the proposed settlement is fair, adequate and reasonable under all of the circumstances.
- Upon a showing by the state agency that unrestricted participation during the course of the litigation by the qui tam plaintiff would interfere with or unduly delay the state agency’s prosecution of the case, or would be repetitious, irrelevant or for purposes of harassment, the court may, in its discretion, impose limitations on the qui tam plaintiff’s participation, such as:
(1) limiting the number of witnesses the qui tam plaintiff may call;
(2) limiting the length of testimony of such witnesses;
(3) limiting the qui tam plaintiff’s cross examination of witnesses; or
(4) otherwise limiting the qui tam plaintiff’s participation in the litigation.
- Upon a showing by a defendant that unrestricted participation during the course of litigation by the qui tam plaintiff would be for purposes of harassment or would cause the defendant undue burden or unnecessary expense, the court may limit the participation by the qui tam plaintiff in the litigation.
- If a state agency elects not to proceed with the action, the qui tam plaintiff shall have the right to conduct the action. If the state agency so requests, the qui tam plaintiff shall serve the state agency with copies of all pleadings filed and all deposition transcripts in the case, at the state agency’s expense. When the qui tam plaintiff proceeds with the action, the court, without limiting the status and rights of the qui tam plaintiff, may permit the state agency to intervene at a later date upon a showing of good cause.
- Whether or not a state agency proceeds with the action, upon a showing by the state agency that certain actions of discovery by the qui tam plaintiff would interfere with the state’s investigation or prosecution of a criminal or civil matter arising out of the same facts, the court may stay such discovery for a period of not more than sixty days. The showing by the state agency shall be conducted in camera. The court may extend the sixty-day period upon a further showing in camera that the state has pursued the criminal or civil investigation or proceeding with reasonable diligence and any proposed discovery in the civil action will interfere with the ongoing criminal or civil investigation or proceeding.
Section 7. AWARDS TO QUI TAM PLAINTIFF AND THE STATE.–
- Except as otherwise provided in this section, if a state agency proceeds with an action brought by a qui tam plaintiff and the state prevails in the action, the qui tam plaintiff shall receive:
(1) at least fifteen percent but not more than twenty-five percent of the proceeds of the action or settlement, depending upon the extent to which the qui tam plaintiff substantially contributed to the prosecution of the action; or
(2) no more than ten percent of the proceeds of the action or settlement if the court finds that the action was based primarily on disclosures of specific information, not provided by the qui tam plaintiff, relating to allegations or transactions in a criminal, civil, administrative or legislative hearing, proceeding, report, audit or investigation or from the news media, taking into account the significance of the information and the role of the qui tam plaintiff in advancing the case to litigation.
- If a state agency does not proceed with an action brought by a qui tam plaintiff and the state prevails in the action, the qui tam plaintiff shall receive an amount that is not less than twenty-five percent or more than thirty percent of the proceeds of the action or settlement, as the court deems reasonable for collecting the civil penalty and damages.
- Whether or not a state agency proceeds with an action brought by a qui tam plaintiff:
(1) if the court finds that the action was brought by a person that planned or initiated the violation of Section 3 of the Fraud Against Taxpayers Act upon which the action was based, the court may reduce the share of the proceeds that the person would otherwise receive under Subsection A or B of this section, taking into account the role of the person as the qui tam plaintiff in advancing the case to litigation and any relevant circumstances pertaining to the violation; or
(2) if the person bringing the action is convicted of criminal conduct arising from that person’s role in the violation of Section 3 of the Fraud Against Taxpayers Act upon which the action was based, that person shall be dismissed from the civil action and shall not receive a share of the proceeds. The dismissal shall not prejudice the right of the state agency to continue the action.
- Any award to a qui tam plaintiff shall be paid out of the proceeds of the action or settlement, if any. The qui tam plaintiff shall also receive an amount for reasonable expenses necessarily incurred in the action plus reasonable attorney fees; provided that if a qui tam plaintiff receives a reduced award pursuant to Paragraph (1) of Subsection C of this section, the court shall also reduce or not award attorney fees and costs.
- The state is entitled to all proceeds collected in an action or settlement not awarded to a qui tam plaintiff. The state is also entitled to reasonable expenses incurred in the action plus reasonable attorney fees, including fees for state agency counsel. Proceeds and penalties collected by the state shall be deposited as follows:
(1) proceeds in the amount of the false claim and attorney fees and costs shall be returned to the fund or funds from which the money, property or services came;
(2) civil penalties shall be deposited in the current school fund pursuant to Article 12, Section 4 of the constitution of New Mexico; and
(3) all remaining proceeds shall be deposited in the general fund.
Section 8. AWARD OF ATTORNEY FEES AND COSTS TO DEFENDANT.–If a state agency does not proceed with the action and the qui tam plaintiff conducts the action, the court may award a defendant reasonable attorney fees and costs if the defendant prevails and the court finds the action clearly frivolous, clearly vexatious or brought primarily for purposes of harassment.
Section 9. CERTAIN ACTIONS BARRED.–
- No court shall have jurisdiction over an action brought pursuant to Section 5 of the Fraud Against Taxpayers Act by a present or former employee of a state agency unless the employee, during employment with the agency and in good faith, exhausted existing internal procedures for reporting false claims and the agency failed to act on the information provided within a reasonable period of time.
- No court shall have jurisdiction over an action brought pursuant to Section 5 of the Fraud Against Taxpayers Act against an elected or appointed state official, a member of the state legislature or a member of the judiciary if the action is based on evidence or information known to the state agency or to the attorney general when the action was brought.
- No court shall have jurisdiction over an action brought pursuant to Section 5 of the Fraud Against Taxpayers Act when that action is based on allegations or transactions that are the subject of a criminal, civil or administrative proceeding in which the state is a party.
- Upon motion of a state agency, a court may, in its discretion, dismiss an action brought pursuant to Section 5 of the Fraud Against Taxpayers Act if the elements of the alleged false claim have been publicly disclosed in the news media or in a publicly disseminated governmental report at the time the complaint is filed.
Section 10. STATE NOT LIABLE.–A state agency is not liable for expenses or fees that a qui tam plaintiff may incur in investigating or bringing an action pursuant to the Fraud Against Taxpayers Act.
Section 11. EMPLOYER INTERFERENCE WITH EMPLOYEE DISCLOSURE–PRIVATE ACTION FOR RETALIATION.–
- An employer shall not make, adopt or enforce a rule, regulation or policy preventing an employee from disclosing information to a government or law enforcement agency or from acting in furtherance of a fraud against taxpayers action, including investigating, initiating, testifying or assisting in an action filed or to be filed pursuant to the Fraud Against Taxpayers Act.
- An employer shall not discharge, demote, suspend, threaten, harass, deny promotion to or in any other manner discriminate against an employee in the terms and conditions of employment because of the lawful acts of the employee on behalf of the employee or others in disclosing information to a government or law enforcement agency or in furthering a fraud against taxpayers action, including investigating, initiating, testifying or assisting in an action filed or to be filed pursuant to the Fraud Against Taxpayers Act.
- An employer that violates Subsection B of this section shall be liable to the employee for all relief necessary to make the employee whole, including reinstatement with the same seniority status that the employee would have had but for the violation, two times the amount of back pay with interest on the back pay, compensation for any special damage sustained as a result of the violation and, if appropriate, punitive damages. In addition, an employer shall be required to pay the litigation costs and reasonable attorney fees of the employee. An employee may bring an action pursuant to this section in any court of competent jurisdiction.
Section 12. LIMITATION OF ACTIONS–ESTOPPEL–STANDARD OF PROOF.–
- A civil action pursuant to the Fraud Against Taxpayers Act shall not be brought more than three years after the date when facts material to the right of action are known or reasonably should have been known, and in no event shall such an action be brought more than ten years after the date on which the violation was committed.
- Notwithstanding any other provision of law, a final judgment rendered in a criminal proceeding charging fraud or false statement, whether upon a guilty verdict after trial or upon a plea of guilty or nolo contendere, shall estop the defendant from denying the essential elements of a fraud against taxpayers action where the criminal proceeding concerns the same transaction that is the subject of the fraud against taxpayers action.
- In an action brought pursuant to the Fraud Against Taxpayers Act, the state agency or the qui tam plaintiff shall be required to prove all essential elements of the cause of action, including damages, by a preponderance of the evidence.
Section 13. JOINT AND SEVERAL LIABILITY.–Liability shall be joint and several for any act committed by two or more persons in violation of the Fraud Against Taxpayers Act.
Section 14. REMEDY NOT EXCLUSIVE.–The remedies provided for in the Fraud Against Taxpayers Act are not exclusive and shall be in addition to any other remedies provided for in any other law or available under common law.
Section 15. SEVERABILITY.–If any part or application of this act is held invalid, the remainder of the act and its application to other persons or situations shall not be affected.
Section 16. EFFECTIVE DATE.–The effective date of the provisions of this act is July 1, 2007.