AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

• Res-Care of New Mexico, Inc., a service provider for individuals with developmental disabilities, had contracts with the New Mexico Department of Health (DOH), Department of Human Services (HSD), and Children, Youth and Families Department (CYFD) for service provision. After terminating services, Res-Care claimed it was owed fees for services already provided. Disputes arose regarding payment, leading to Res-Care filing a breach of contract claim against the Departments, alleging unpaid services under the contracts (paras 2-3).

Procedural History

• District Court of Santa Fe County, Sarah M. Singleton, District Judge: Dismissed CYFD from the case due to lack of a written contract and later determined that Res-Care failed to exhaust administrative remedies, dismissing their case against DOH and HSD (paras 3, 15).

Parties' Submissions

• Plaintiff-Appellant (Res-Care of New Mexico, Inc.): Argued that it had not been paid for services provided under contracts with the Departments and that it was entitled to notice of the right to appeal the denial of payments (paras 3, 10-14).
• Defendants-Appellees (State of New Mexico ex rel., New Mexico Department of Health, New Mexico Department of Human Services, and New Mexico Children, Youth and Families Department): Contended that Res-Care failed to exhaust available administrative remedies before bringing a breach of contract claim and that denial of a claim due to billing error constitutes notice of an action that could be appealed without requiring notice of the right to appeal (para 1).

Legal Issues

• Whether the appeal against CYFD was timely under Rule 1-054 NMRA (para 4).
• Whether Res-Care had exhausted all available administrative remedies before filing a breach of contract claim against the Departments (para 10).

Disposition

• The appeal against CYFD was dismissed as untimely under Rule 1-054 (para 9).
• The district court's decision that Res-Care failed to exhaust its administrative remedies was affirmed, leading to the dismissal of its claims against DOH and HSD (para 15).

Reasons

• RODERICK T. KENNEDY, Chief Judge, with CYNTHIA A. FRY, Judge, and MICHAEL E. VIGIL, Judge concurring, provided the opinion. The court found that the separate agencies (DOH, HSD, CYFD) should be considered separate parties for the purposes of appeal under Rule 1-054, rather than branches of the State as a single entity, making Res-Care’s appeal against CYFD untimely (paras 5-9). Furthermore, the court agreed with the district court's determination that Res-Care failed to exhaust administrative remedies available to it before proceeding with a breach of contract claim. The court held that the denial of a claim due to billing error was sufficient notice of an action that could be appealed and did not require additional notice of the right to appeal. This decision was based on the interpretation of administrative regulations governing reimbursement disputes and the processes outlined for appealing such decisions (paras 10-14).