New Mexico AG sues Presbyterian Health Plan for alleged tax fraud

New Mexico's attorney general sued Albuquerque, N.M.-based Presbyterian Health Plan and two affiliated organizations for allegedly underpaying premium taxes.

New Mexico law requires insurers pay a premium tax and surcharge for operating in the state. The New Mexico Office of the Attorney General claimed Presbyterian submitted false Medicaid claims for deductions and credits, "thereby evading tens of millions of dollars" in taxes.

Attorney General Hector Balderas filed the lawsuit in the First Judicial District Court in Santa Fe, N.M., July 11. The lawsuit claims Presbyterian Health Plan, Presbyterian Network and Presbyterian Insurance Co. routinely falsified its Medicaid deductions and credits between 2001 and 2015.

Presbyterian "vehemently" rejected the allegations. Prebyterian said it is "genuinely alarmed and surprised by the timing and nature of these allegations. The premium taxes paid by Presbyterian Health Plan have been audited multiple times by independent firms and state agencies. We have consistently and fully participated in the review of our financial records, including the audit currently underway by the Office of the Superintendent of Insurance."

The health plan paid more than $52.6 million in premium taxes to New Mexico in 2016, Presbyterian said.   

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