New Mexico Forms Library

14-4415. Medicaid fraud; executing plan or conspiracy to execute plan for delivery or payment of benefits by fraud or fraudulent representation.

            For you to find the defendant guilty of Medicaid fraud as charged in Count ____, the State must prove to your satisfaction beyond a reasonable doubt each of the following elements of the crime:

            1.         The defendant [executed] [conspired to execute²]¹ a plan or action to obtain by false or fraudulent representation⁴ or promise, _______________³, which is anything of value, in connection with the delivery of or payment for health care benefits.

            2.         The health care benefits were in whole or in part, [paid for] [reimbursed] [subsidized]¹ by a state or federally funded or mandated managed health care plan.

            3.         This happened in New Mexico on or about the __________ day of ______________, __________.⁵

USE NOTES

            1.         Use only the applicable bracketed elements established by the evidence.

            2.         UJI 14-2810 NMRA should be given if conspiracy is alleged.

            3.         Name item.

            4.         See NMSA 1978, § 30-44-7(A)(4)(b) for a list of fraudulent representations or statements anticipated by the statute.

            5.         The applicable definition or definitions from UJI 14-4401 NMRA must be given after this instruction.

[Adopted by Supreme Court Order No. 14-8300-005, effective for all cases filed or pending on or after December 31, 2014.]