New Mexico Administrative Code

Public Health Emergency Response Act (Act), Section 12-10A-1 et seq, NMSA 1978; and Subsection E of Section 9-7-6, NMSA 1978.

Permanent.

September 15, 2020, unless a later date is cited at the end of a section.

The objective of this rule is to provide administrative procedural rules to govern the appeal of a civil monetary penalty that is assessed by the department under the Act.

A. Appellant means a person who is served a notice of contemplated action for imposition of a civil monetary penalty pursuant to the Act at Section 12-10A-19 NMSA 1978, who timely submits a request for hearing, in accordance with this rule, to contest the proposed penalty. B. Dep…

A. Right to hearing: A person may request an administrative hearing before a hearing officer appointed by the secretary or his or her designee, to appeal the proposed imposition of a civil monetary penalty pursuant to the Act at Section 12-10A-19 NMSA 1978. An appellant may reque…

New Mexico Department of Health.

Public record: A. The claims data provided to the database, the database itself, including the data compilation, and any raw data received from the database are not public records and are generally exempt from public disclosure in accordance with the Inspection of Public Records …

A. Access requirements: Data and reports based on the claims database may be obtained only in accordance with the requirements of the HIS Act and this rule. Any request for information that would not be contained in previously prepared and published reports will require a data re…

A. Access to routine and published reports: The department shall release reports to the public on a periodic schedule as determined by the department and in accordance with the HIS Act. B. Access to aggregate data and reports for individuals: Pursuant to the requirements of the N…

A. Fees for routine reports: (1) Generally: The fees for copies of available reports produced for public use shall be as follows:(a) single copies of any claims data reports or annual reports shall be provided free of charge upon request; and (b) all other reports shall be provid…

These regulations govern the creation and maintenance of a repository of healthcare claims data to be used to increase the quality and effectiveness of health care delivered in New Mexico.

The requirements set forth herein are promulgated by the secretary of the department of health pursuant to the authority granted under Subsection E of Section 9-7-6, NMSA 1978, and the Health Information System Act, 24-14A-1 et seq. NMSA 1978.

Permanent.

April 20, 2021, unless a later date is cited at the end of a section.

The objective of this rule is to establish provisions that govern the creation, maintenance, and usage of a repository of healthcare claims data for the purpose of improving health care cost and quality.

A. "Allowed amount" means the negotiated amount eligible for payment for a health care service or item rendered by a provider. B. "Billed amount" means the amount billed by a provider requesting payment for health care services or items rendered. C. "Claim" means a financial acco…

A. Duties of the department: (1) The department shall establish a statewide all-payer claims database to support transparent public reporting of health care information. The database must improve transparency to: assist patients, providers, and hospitals to make informed choices …

A. All-payer claims database data providers: (1) Data providers must submit all available data and health information with necessary identifiers to the database as described in the APCD-Common Data Layout (APCD-CDLT, Version 2.1 with errata, Copyright 2021 by APCD Council, Nation…

(Reserved.)

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New Mexico Health Policy Commission.

A. Schedule for reporting: Beginning with the first quarter of 2011 (January 1-March 31), all licensed nonfederal general and specialty inpatient health care facilities in New Mexico shall submit to the commission on a quarterly basis the data required by this rule, in accordance…

Starting with 2011 data, all data providers shall submit the required quarterly discharge data pursuant to the reporting schedule contained in Subsection A of 7.1.4.10 NMAC and all final corrected reports, for the full year's worth of data, are due no later than May 31of the foll…

Upon written application to the commission, the commission may grant a health care facility a temporary exemption, not to exceed two reporting quarters, from the schedule required by Subsection A of 7.1.4.10 NMAC. Temporary exemption from reporting does not excuse the health care…

Failure to comply with any of the reporting requirements in this rule may result in injunctive relief and a civil penalty not to exceed $1,000 per violation, as provided by the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978.

This rule applies to all licensed inpatient and outpatient general and specialty health care facilities located within New Mexico.

This rule is promulgated pursuant to Sections 24-14A-3 D(5) and (6); 24-14A-5 A through C; 24-14A-8 A and B; and 24-14A-9 of the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978.

Permanent.

November 14, 2008, unless a later date is cited at the end of a section.

The purpose of this rule is to specify the data reporting requirements for licensed inpatient and outpatient general and specialty health care facilities pursuant to the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978.

In addition to the definitions in the Health Information System Act, Section 24-14A-1 et seq. NMSA 1978, the following terms have the following meaning for purposes of this rule. A. Admission hour coded in military time (e.g., 2:45 p.m. is represented as 1445). B. Attending physi…

[Reserved]

All data and health information collected from data sources shall become the property of the commission upon receipt.

NM Department of Health, Harold Runnels Building, 1190 St. Francis Drive, P.O. Box 26110, Santa Fe, NM 87502-6110.

Pre-proposal conferences may be held to explain the procurement process and requirements. Conferences shall be held long enough after the request for proposals has been published to allow offerors to become familiar with it, but sufficiently before the deadline for submission of …

A. Completed proposals shall be returned to the department as specified in the notice of the request for proposals. The organizational unit of the department receiving the completed proposal shall establish a log of all proposals received which shall include the date and time the…

A. Negotiations may be conducted by the central purchasing office or the department unit for whom the services or professional services are to be provided with responsible offerors who submit proposals found to be reasonably likely to be selected for the award. B. The above provi…

A. The evaluation of submitted competitive sealed proposals shall be conducted by the department unit which caused the request for proposals to be issued. The evaluation shall be based on the evaluation factors and relative weights set forth in the request for proposals. B. At le…

A. The award shall be made to the responsible offeror or offerors whose proposal is most advantageous to the department, taking into consideration the evaluation factors set forth in the request for proposals. B. If, upon evaluation of all submitted proposals, a determination is …

A. The central purchasing office or procuring unit of the department may procure professional services having a value not exceeding twenty thousand dollars ($20,000) excluding applicable state and local gross receipts taxes, except for the services of architects, landscape archit…

Department contracts shall include a clause imposing late payment charges against the department in the amount and under the conditions stated in Section 13-1-158 NMSA 1978.

General Public