facebook-24x24

Santa Fe, NM - Today, Attorney General Hector Balderas announced that he has filed a lawsuit against Presbyterian Health Plan, Inc., and Presbyterian Healthcare Services for fraud based on the systematic, deliberate underpayment of taxes on premiums received or written. The Office of the Attorney General's complaint alleges that between 2001 and 2015, Presbyterian routinely filed false claims for premium tax deductions and credits, thereby defrauding the people of New Mexico and evading its legal duty to pay these taxes. The Presbyterian lawsuit is the first action brought by the Attorney General as part of his independent civil and criminal review, which is ongoing, and this lawsuit is limited to Presbyterian's alleged false claims for reductions related to the Medicaid program.

"New Mexicans deserve a healthcare system they can trust," said Attorney General Balderas. "When insurance providers break the rules, they must face consequences. My office is working with the State Auditor to make sure that Presbyterian—and any other companies that engaged in similar fraudulent conduct—are held responsible for the serious injuries imposed on New Mexican taxpayers."

Under New Mexico law, every insurer doing business in New Mexico is required to pay a premium tax and surcharge. According to the Office of the Attorney General's complaint, Presbyterian falsified its Medicaid deductions and credits, thereby evading tens of millions of dollars in premium taxes and surcharges.

The complaint includes counts for violation of the Fraud Against Taxpayers Act, violation of the New Mexico Insurance Code, unjust enrichment, fraud, and negligent misrepresentation. In addition to seeking millions of dollars in unpaid taxes, the complaint seeks civil penalties and punitive damages. The Office of the Attorney General, as chief prosecutor in the State of New Mexico, is taking control of a lawsuit previously filed by whistleblowers in the Office of the Superintendent of Insurance.

The New Mexico Office of the Attorney General is a statewide law enforcement and oversight agency with both criminal and civil jurisdiction. In November 2016, the Legislative Finance Committee, the Department of Finance and Administration, and the Officer of the State Auditor requested the Attorney General's assistance in reviewing potential underpayments of premium tax by major healthcare companies.

The Attorney General's comprehensive civil and criminal review of allegations related to potential underpayment by Presbyterian and other healthcare companies is ongoing. The Office of the Attorney General remains open to further actions and prosecutions as more evidence comes to light.


Can't see this document? Click this link to view it in a new window

Join GCB Three Times Weekly Updates

Welcome to Three Times Weekly Updates! You will be subscribed to email notifications with links to recently posted articles.
captcha 
You can unsubscribe anytime. We never share or rent your email to anyone.

Fire Alerts

Editor's Note

The Beat as a new column for you gardeners out there. The Grant County Extension Service will bring you monthly columns on gardening issues. The first one posted is on Winterizing your houseplants and patio plants.

The Beat totally appreciates its readers!  

WARNING:

All articles and photos indicated by a byline are copyrighted to the author or photographer. You may not use any information found within the articles without asking permission AND giving attribution to the source. Photos can be requested and may incur a nominal fee for use personally or commercially.

Don't forget to tell advertisers that you saw their ad on the Beat.

Feel free to notify editor@grantcountybeat.com, if you notice any problems on the site. Your convenience is my desire for the Beat.

We are a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for us to earn advertising fees by advertising and linking to Amazon.com.

If you subscribe to the Join GCB Three Times Weekly Updates option on the left side of this page, you will be subscribed to email notifications with links to recently posted articles.

Note: This is another component that is in progress of going to a different software to make it easier for you to use and find classifieds that interest you. Check Out Classifieds. And look at Sponsors to see who is helping the Beat.

It's really easy to check to see if there's a classified ad. Just click on Classifieds in the blue menu and the page will open letting you know if there is a classified ad. Remember that your buying classified ads gives you a wide readership, as well as supporting the Beat. Post YOURS for quick results!

Note that if an article does not have a byline, it was sent to the Beat and written by someone not affiliated with the Beat

When you click on the blue and orange button on the upper left side of most pages, you will find out how you can help the Beat defray its expenses, which, with increased readership, continue to grow. You will arrive at a page that gives you options of how you can Help the Beat. All help is greatly appreciated and keeps the news you want and need coming into your browser.

Consider the Beat your DAILY newspaper for up-to-date information about Grant County. It's at your fingertips! One Click to Local News.

Thanks for your support for and your readership of Grant County's online news source—www.grantcountybeat.com