New Mexico Administrative Code

To establish regulations for administration of the Summer Food Service Program, including requirements for participating sponsoring organizations.

A. "Academic-Year NYSP" means that portion of the National Youth Sports Program operating drug awareness and counseling programs during the months October through April, as authorized under Public Law 100-690, the Anti-Drug Abuse Act of 1988. B. "Act" means the National School Lu…

A. CYFD/Family Nutrition Bureau (FNB) enters into agreement with any non profit (501-c-3) organization which meets the established USDA program criteria in 7 CFR 225 and subsection B of 8.2.3.8 NMAC. B. Any non-profit organization wishing to participate as a sponsoring organizati…

A. CYFD conducts Program monitoring and provides Program assistance to sponsors during on site reviews. (1) Pre-approval visits are conducted by CYFD staff for all new sponsors and sites, to assess the applicant's site potential for successful Program operations and to verify inf…

New Mexico Health Care Authority (HCA).

A. Except where noted, the HCA income support division (ISD) determines eligibility in the categories listed below:(1) other adult (Category 100); (2) parent caretaker (Category 200); (3) pregnant women (Category 300); (4) pregnancy-related services (Category 301); (5) loss of pa…

PE provides immediate access to health services when an individual appears to be eligible for Category 052. A. Breast and cervical cancer (BCC) (Category 052): PE provides temporary medicaid coverage for an uninsured woman, under the age of 65 who has been screened and diagnosed …

A. HCA provides continuous eligibility for the period specified in Subsection B and C of 8.200.400.12 NMAC for an individual who is:(1) Under age 19 and (2) Eligible and enrolled for mandatory or optional coverage under the state plan. B. The continuous eligibility period is up t…

HCA must permit applicants and beneficiaries to designate an individual or organization to act responsibly on their behalf in assisting with the individual's application and renewal of eligibility and other ongoing communications. A. Such a designation must be in writing includin…

A. HCA must make eligibility for medicaid effective no later than the first or up to the third month before the month of application if the individual: (1) Requested coverage for months prior to the application month; (2) received medicaid services, at any time during that period…

A. SSI recipients entitled to premium-free part A: Effective October 1, 2024, the HCA shall automatically deem SSI recipients into QMB the first month they are eligible for SSI Medicaid and entitled to premium-free part A. The start of the part B buy-in coverage is the first mont…

The rule applies to the general public.

The New Mexico medicaid program and other health care programs are administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See Section 27-1-12 et seq., NMSA …

Permanent.

January 1, 2019, or upon a later approval date by the federal centers for medicare and medicaid services (CMS), unless a later date is cited at the end of the section.

The objective of this rule is to provide specific instructions when determining eligibility for the medicaid program and other health care programs. Generally, applicable eligibility rules are detailed in the medical assistance division (MAD) eligibility policy manual, specifical…

We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.

Medicaid services are jointly financed by the federal government and the state of New Mexico and are administered by medical assistance division (MAD). A. Within broad federal regulations, New Mexico determines categories of eligible recipients, eligibility requirements, types an…

New Mexico Health Care Authority.

Federal law requires, as a condition of eligibility, that each individual (including children) seeking medicaid furnish each of his or her social security numbers (SSN). A HSD will advise the applicant of:(1) the statute or other authority under which the agency is requesting the…

To be eligible for medicaid, an individual must be a citizen of the United States; United States national or a non-citizen who meets the requirements set forth in either Subsection A or B of 8.200.410.11 NMAC. A. Non-citizens who entered the United States prior to August 22, 1996…

A. Stand-alone evidence of citizenship: The following must be accepted as sufficient documentary evidence of citizenship: (1) A U.S. passport, including a U.S. passport card issued by the department of state, without regard to any expiration date as long as such passport or card …

A. HSD provides a reasonable opportunity period to individuals who have made a declaration of citizenship or satisfactory immigration status in accordance with 42 CFR 435.406, and for whom the HSD is unable to verify citizenship or satisfactory immigration status. During the reas…

To be eligible for medicaid, an applicant or eligible recipient must be living in New Mexico on the date of application and final determination of eligibility and have demonstrated an intention to remain in the state. A. Establishing residence: Residence is established by living …

A. An applicant or an eligible recipient receiving medicaid in another state is not medical assistance program eligible in New Mexico except when: (1) institutional care medicaid begins on a specific date within the month rather than automatically reverting to the first day of th…

As a condition of eligibility, a medicaid applicant or an eligible recipient must take all necessary steps to obtain any annuities, pensions, retirement, and disability benefits to which they are entitled, within 30 calendar days from the date HSD furnishes notice of the potentia…

A. A public institution is a: (1) state and private correctional facility; (2) county and privately operated jail; (3) department of health behavioral health facility forensic unit; (4) detention facility operated under the authority of CYFD; or (5) facility that is operated unde…

A. Beginning August 1, 2019, HSD automatically enrolls into medicare part B individuals: (1) who are active on a full medicaid or medicare savings program category of eligibility with the exception of the following categories: (a) other adults (COE 100); (b) newborn (COE 031); (c…

The rule applies to the general public.

The New Mexico medicaid program and other health care programs are administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See Section 27-1-12 et seq., NMSA …

Permanent.

October 1, 2017, unless a later date is cited at the end of a section.

The objective of this rule is to provide specific instructions when determining eligibility for the medicaid program and other health care programs. Generally, applicable eligibility rules are detailed in the medical assistance division (MAD) eligibility policy manual, specifical…

To transform lives. Working with our partners, we design and deliver innovative, high quality health and human services that improve the security and promote independence for New Mexicans in their communities.

To be eligible or continue eligibility for medicaid or other medical assistance programs, an applicant or eligible recipient must meet specific non-financial requirements. In addition to the rules in this chapter, refer to 8.100.130 NMAC regarding the following requirements: A. c…

New Mexico Health Care Authority.

School attendance is a factor in determining JUL medicaid eligibility for 18 year-old applicants or re-determining recipients. School attendance is not a factor in determining JUL medicaid for children under the age of 18 years.

For an individual applying for a specific medical assistance division (MAD) category of eligibility, disability is a condition of eligibility. The determination of disability is made by the disability determination services unit. The social security administration's (SSA) definit…

Refer to 8.200.430.13 NMAC.

Refer to 8.200.430.20 NMAC.

The rule applies to the general public.

The New Mexico medicaid program and other health care programs are administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See NMSA 1978, Section 27-1-12 et …

Permanent.

January 1, 2014, unless a later date is cited at the end of a section.

The objective of this rule is to provide specific instructions when determining eligibility for the medicaid program and other health care programs. Generally, applicable eligibility rules are detailed in the medical assistance division (MAD) eligibility policy manual, specifical…

[RESERVED]

To reduce the impact of poverty on people living in New Mexico by providing support services that help families break the cycle of dependency on public assistance.