N.M. Admin. Code § 8.354.2.19

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.354.2.19 - JUDICIAL APPEAL

If the HSD administrative hearing final decision upholds MAD, its UR contractor, the MCO or their designee's intended or taken adverse action, the claimant or the claimant's authorized representative has the right to pursue judicial review of the HSD administrative hearing final decision and is notified of that right in the HSD administrative final decision letter. Judicial appeals for the HSD administrative hearing final decision are governed by New Mexico statutes and court rules. While the following subsections highlight applicable procedures, they should not be considered a substitute for examining the statutes and rules themselves.

A.Jurisdiction: Administrative appeals for a claimant are governed by the Section 39-3-1.1 NMSA 1978 and by Rule 1-074, Rules of Civil Procedures for the district courts.

B.Timeliness: Unless otherwise provided by law, a claimant or the claimant's authorized representative must appeal the HSD administrative hearing final decision within 30 calendar days of the date of the HSD administrative hearing final decision by filing a notice of appeal with the clerk of the appropriate New Mexico district court.

C.Jurisdiction and standard of review: All judicial appeals are based on the record made at the HSD administrative hearing, and in accordance with state statute and court rules. HSD files a copy of the HSD administrative hearing record with the court clerk and furnishes one copy to the claimant or the claimant's authorized representative and if applicable, his or her legal counsel within 30 calendar days after receipt of the notice of appeal. The court may set aside the HSD administrative hearing final decision if it finds the decision is:

(1) arbitrary, capricious, or an abuse of discretion;

(2) is not supported by substantial evidence in the record as a whole; or

(3) is otherwise not in accordance with the applicable law, statutes or rules.

D.Benefits pending state district court appeal: The filing of a notice of appeal shall not stay the enforcement of the HSD administrative hearing final decision. The claimant or the claimant's authorized representative may seek a stay upon a motion to the court or the claimant may request the MAD director or designee to stay the HSD administrative hearing final decision while the adverse action is on appeal in a New Mexico district court. If the court orders a stay, MAD, it UR contractor, the MCO or their designee will maintain the benefit at issue in accordance with the state district court's order. If the New Mexico district court's final decision is in favor of MAD, its UR contractor, the MCO or their designee and the claimant continued utilizing his or her benefit during the district court appeal process, see 8.352.2 NMAC for the repayment process.

N.M. Admin. Code § 8.354.2.19

8.354.2.19 NMAC - Rp, 8.354.2.16 NMAC, 8/1/14