Jan. 9—The state Supreme Court held Thursday that the lower courts must reconsider whether three women whose lawsuit helped the state collect millions of dollars from one of New Mexico's largest health insurers are entitled to a greater share of the money they helped recover.
A First District Court judge had previously ruled the three weren't entitled to more money, a decision upheld by the Court of Appeals.
Monica Galloway, Shawna Maestas and Jolene Gonzales, former employees of the New Mexico Office of the Superintendent of Insurance, filed a whistleblower complaint in 2016 accusing Presbyterian Health Plan of avoiding tax liability through fraudulent practices. The women testified they filed their lawsuit — which accused Presbyterian Health of cooking its books to avoid tax liability, among other things — after they reported their findings to their boss, then-Superintendent of Insurance John Franchini, and he refused to take action.
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Under the Fraud Against Taxpayers Act, citizens who suspect government fraud can file their own lawsuit but the Attorney General's Office gets a chance to prosecute the allegations first if it wishes. Then-Attorney General Hector Balderas brought a case against Presbyterian accusing the company of improperly claiming tax credits in 2003 and 2004, later reaching a settlement in which the insurer agreed to pay $18.5 million but admitted no wrongdoing.
The three women were part of that settlement and collected 20% of the money, or...
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