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State Sues Presbyterian Over Alleged Fraud

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New Mexico’s top prosecutor is taking one of the state’s largest health care providers to court over alleged tax fraud. Attorney General Hector Balderas announced the lawsuit against Presbyterian Health Services yesterday.

Every insurer here is required by law to pay a premium tax and a surcharge. That money makes up a significant chunk of the state’s revenues.

But according to Balderas, Presbyterian has been cheating the state out of money by falsifying Medicaid deductions and credits since 2001.

Ken Stalter is general counsel for the AG’s office.

"This continued year after year," Stalter explained. "That’s why we say that they deliberately and systematically defrauded the taxpayers of the state of New Mexico."

Stalter says the alleged fraud is especially serious since the state is in a budget crisis because of low oil and gas prices.

"Presbyterian is charging their patients, asking them to pay their fair share," Stalter said. "They need to do the same and pay their fair share to the state of New Mexico."

Presbyterian denies the allegations, and said it paid the state over $70 million last year alone.

This suit is part of the AG’s ongoing investigation of health insurers in New Mexico.

Ed Williams came to KUNM in 2014 by way of Carbondale, Colorado, where he worked as a public radio reporter covering environmental issues. Originally from Austin, Texas, Ed has reported on environmental, social justice, immigration and Native American issues in the U.S. and Latin America for the Austin American-Statesman, Z Magazine, NPR’s Latino USA and others. In his spare time, look for Ed riding his mountain bike in the Sandias or sparring on the jiu-jitsu mat.
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