New Mexico Administrative Code

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

The objective of these regulations is to provide general policy and procedures for income support division (ISD) administered programs.

Various records, forms and documents have differing periods of relevance and usefulness. Certain material in the record should be deleted on a scheduled basis when the material is no longer needed. To facilitate record management, as well as to establish the minimum period of tim…

A. P-retain permanently: Forms and documents must be retained in the case record permanently. B. 4-retain four years: Federal regulations provide that fiscal documents must be retained for three years after the end of the period to which they apply. By retaining these records for…

New Mexico Health Care Authority.

Before any action to withhold a cash assistance payment or to reduce or terminate medical, food stamp or cash assistance benefits, the HCA must issue timely and adequate advance notice of an adverse action. A. Adverse action defined: Adverse action means an action taken by HCA th…

A concurrent notice is one which is mailed no later than the date the benefit is or would have been received. It is also referred to as an adequate notice. A. Food stamps: HCA notifies a household that its FS benefits are reduced or terminated no later than the date the household…

Adverse action notices are not required under the following conditions. A. Mass changes: The state initiates a mass change. B. Death: The ISS determines, based on reliable information, that all members of a household have died. C. Move from project area: The ISS determines, based…

If the agency obtains facts indicating that FA or MA should be suspended, terminated or reduced because of probable fraud by the recipient which has been verified, if possible, by collateral sources, notice of the action being taken is mailed at least five days before the action …

If a fair hearing request is filed, benefits are continued, under the circumstances described below, until the fair hearing determination is completed. A. Timely requests: (1) Advance notice: If a household requests a fair hearing within the advance notice period provided by the …

A. General: Certain changes initiated by the state or federal government may affect the entire caseload or significant portions of it. These changes include, but are not limited to, increases or decreases in eligibility or payment standards changes in excluded or deducted items o…

If a client and the ISS disagree about the continuation of benefits, the client may request a fair hearing. Adverse action defined. "Adverse action" is action taken by HCA which adversely affects the amount of benefits a client receives. Such actions include holding mailing of as…

The worker shall give advance notice to an applicant or recipient of any visit to the applicant's or recipient's home. A. Verbal notice: The advance notice may be in the form of a verbal communication between the worker and the applicant or recipient. The time and date of the vis…

The rule applies to the general public.

A. Section 27 NMSA 1978 (1992 Repl.) provides for the health care authority to "...adopt, amend and repeal bylaws, rules and regulations...." It also provides for administration of public assistance programs. B. The income support division (ISD) of the health care authority (HCA)…

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

The objective of these regulations is to provide general policy and procedures for income support division (ISD) administered programs.

Both oral and written communications with applicants/recipients must be courteous. ISD shall inform the client promptly and in accord with state and federal regulations of actions relating to an application or ongoing case.

Prompt notification of action on a specific application is required. See specific program sections in this manual.

New Mexico Health Care Authority.

Forms that are generated by automated systems are controlled by the information systems bureau general supporting policy 8.100.390 NMAC.

For forms stored at the HCA central warehouse, originating staff should consult the warehouse manager to determine: inventory status of the form; status of outstanding orders; and estimated date the form supply will be exhausted. This information will be used to determine the qua…

Once notified by the warehouse that a supply of the new or revised form is available, the originating staff will prepare the manual revision cover memo. A copy of the completed manual revision, form, and instructions will be submitted to the ISD forms manager. The forms manager w…

To re-order forms, the originating staff member fills out a form order/re-order memo and submits it to the warehouse manager for processing. The warehouse manager will complete the purchase document and return it to the program staff for signature.

If an originating staff member determines a form is to be discontinued and destroyed, the originating staff will first consult with the forms advisory team. When the discontinuation or destruction of a form is agreed on, the originating staff will fill out a form discontinuation …

The rule applies to the general public.

A. Section 27 NMSA 1978 (1992 Repl.) provides for the health care authority to "...adopt, amend and repeal bylaws, rules and regulations...." It also provides for administration of public assistance programs. B. The income support division (ISD) of the health care authority (HCA)…

Permanent.

July 1, 2024, unless a later date is cited at the end of a section.

The objective of these regulations is to provide general policy and procedures for income support division (ISD) administered programs.

A. Official form defined: An official form is any form with the HCA logo and a number assigned in central office. An official form must include a statement as to the purpose of the form and instructions for completion, distribution, and retention of the form. (1) All statements r…

A. The originating staff will complete a request/format approval form HCA 053 (green copy), attach the approved draft, and submit to the graphics unit. All drafts of proposed new forms submitted to the graphics unit must be typed or printed. The request/format approval form must …

New Mexico Health Care Authority.

A. Entitlement: (1) Program benefits will be restored to an eligibility determination group when the loss was caused by: (a) agency error; (b) SNAP administrative disqualification for IPV that is later reversed; or (c) a regulation specifically requiring restoration of lost benef…

The department shall take action to establish a claim against any eligibility determination group that received more benefits than it was entitled to receive, including LIHEAP benefits paid to a vendor on behalf of the eligibility determination group, whether or not the overpayme…

A. SNAP: (1) Calculating the claim for an IHE and AE: For each month that benefits have been over-issued to an eligibility determination group because of an IHE or AE, the department shall determine the correct benefit amount the eligibility determination group was entitled to re…

The department shall initiate collection action by sending the eligibility determination group an overpayment notice. A. Adverse action notice: If the amount of the claim was not established by a fair hearing decision, the eligibility determination group will be provided with an …

A. Recoupment: The department shall retain the value of benefits collected to repay a claim against a participating eligibility determination group, whether or not the claim occurred because of an IHE, an AE, or an IPV. The eligibility determination group's monthly SNAP or cash a…

A terminated claim is a claim in which all collection action has ceased. The department may terminate a claim for any of the reasons described in Subsections A through E of this section. SNAP, LIHEAP, TANF, AFDC, GA and refugee cash assistance and support services for participati…

Writing off a claim means that the claim is no longer considered a receivable subject to any federal or state collection requirements such as the Treasury Offset Program at 31 CFR 285 or the Supplemental Nutrition Assistance Program at 7 CFR 273.18. A claim may be written off if …

EBT adjustment pertains to any EBT transaction resulting in a change to a client's cash or snap benefits. If a system error causes a customer to receive funds to which they were not entitled or causes their account to not be charged for an EBT transaction, an adjustment may be co…

Stale benefit accounts are those SNAP and cash assistance accounts that have not been accessed for 90 days from the most recent date of withdrawal. A. Offline accounts: If EBT accounts are not accessed for 90 days, the department may store such benefits in an offline account. (1)…

The rule applies to the general public.

A. Chapter 27 NMSA 1978 (1992 Repl.) provides for the health care authority (HCA) to "...adopt, amend and repeal bylaws, rules and regulations..." It also provides for administration of public assistance programs. B. The ISD of the HCA was created by the HCA secretary under autho…

Permanent.