New Mexico Administrative Code

MAD pays for medically necessary services for an eligible recipient under 21 years of age which are designed to develop skills necessary for successful reintegration into their family or transition into their community. A determination must be made that the eligible recipient nee…

MAD pays for coverage for medication assisted treatment for opioid use disorder to an eligible recipient through an opioid treatment center as defined in (42 CFR Part 8), certification of opioid treatment programs (OTP). Services include, but are not limited to, the administratio…

To help an eligible recipient receive the level of services needed, MAD pays for partial hospitalization services furnished by an acute care or freestanding psychiatric hospital. Partial hospitalization programs (PHP) are structured to provide intensive psychiatric care through a…

To help an adult eligible recipient 18 years and older who met the criteria of SMI, MAD pays for psychosocial rehabilitation services (PSR). PSR is an array of services offered in a group setting through a clubhouse or a classroom and is designed to help an individual to capitali…

Recovery services are peer-to-peer support for managed care members to develop and enhance wellness and health care practices. Recovery services promote self-responsibility through recipients learning new health care practices from a peer who has had similar life challenges and w…

SBIRT is a community-based practice designed to identify, reduce and prevent problematic substance use or misuse and co-occurring mental health disorders as an early intervention. Through early identification in a medical setting, SBIRT services expand and enhance the continuum o…

See 8.310.2 NMAC for a detailed description of tobacco cessation services and approved behavioral health providers.

MAD pays for coverage for permanent supportive housing pre-tenancy and tenancy support services (PSH-TSS) to an eligible recipient enrolled in a managed care organization to facilitate community integration and contribute to a holistic focus on improved health outcomes, to reduce…

MAD pays for medically necessary services furnished to an eligible recipient under 21 years of age who has an identified need for treatment foster care (TFC) and meets the TFC I or TFC II level of care (LOC) as part of the EPSDT program. MAD covers those services included in the …

MAD provides coverage for therapeutic intervention services rendered to individuals with mental health disorders. The mental health services rendered shall be necessary to reduce the disability resulting from mental illness and to restore the individual to their best possible fun…

Permanent.

To help eligible recipients receive behavioral health services to MAD pays for FFT services. FFT is an evidence-based, short term and intensive family-based and manual driven treatment program that has been successful in treating a wide range of problems affecting families in a w…

An intensive care coordination service designed as a comprehensive, holistic, youth and family-driven way of responding when children or youth experience serious mental health or behavioral challenges. HFW aligns with the children's system of care (SOC) approach in NM. HFW suppor…

Peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders. A. Eligible practitioners: Must be self-identified consumers wh…

December 10, 2024, unless a later date is cited at the end of a section.

The objective of these rules is to provide instruction for the service portion of the New Mexico medical assistance programs (MAP).

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

A. Health care to New Mexico (NM) eligible recipients is furnished by a variety of providers and provider groups. The reimbursement for these services is administered by the HCA medical assistance division (MAD). Upon approval of a NM MAD provider participation agreement (PPA) a …

New Mexico Health Care Authority - Division of Health Improvement.

To obtain an initial license for a facility pursuant to these regulations the following procedures must be followed by the applicant. A. Application phase: These regulations apply to the design of a new building or renovation or addition to an existing building for licensure as a…

A. Annual license: An annual license is issued for a one year period to a facility which has met all requirements of these regulations. B. Temporary license: The licensing authority may, at its sole discretion, issue a temporary license prior to the initial survey or when it find…

A. Licensee must submit a renewal application on forms provided by the licensing authority, along with the required fee at least 30 days prior to expiration of the current license. B. Upon receipt of renewal application and required fee prior to expiration of their current licens…

The facility's license must be posted on the licensed premises in an area visible to the public.

A license shall not be transferred by assignment, or otherwise, to other persons or locations. The license shall be void and must be returned to the licensing authority when any one of the following situations occur: A. ownership of the facility changes; B. the facility changes l…

A license will automatically expire at midnight on the day indicated on the license as the expiration date, unless renewed, suspended, or revoked, or A. on the day a facility discontinues operation; B. on the day a facility is sold, leased, or otherwise changes ownership or licen…

In accordance with Subsection H of Section 24-1-5 NMSA 1978, if immediate action is required to protect human health and safety, the licensing authority may suspend a license pending a hearing, provided such hearing is held within five working days of the suspension, unless waive…

A license may be revoked or suspended, an initial or renewal application for license may be denied, or intermediate sanctions or civil monetary penalties may be imposed after notice and opportunity for a hearing, for any of the following: A. failure to comply with any provision o…

A. Hearing procedures for an administrative appeal of an adverse action taken by the licensing authority against a facility's license as outlined in Section 16 and 17 above will be held in accordance with adjudicatory hearings, New Mexico health care authority, 8.370.2 NMAC. B. A…

A. Any community mental health center, currently licensed as a limited diagnostic and treatment center on the date these regulations are promulgated and which provides the services prescribed under these regulations, may continue to be licensed as such until that license expires …

A. These regulations apply to the following: (1) outpatient facilities which are certified by the behavioral health services division of the New Mexico health care authority (authority) to provide psychosocial rehabilitation services to adults with priority given to individuals w…

A new facility may be opened in an existing building or a newly constructed building. A. If opened in an existing building, a variance may be granted for those building requirements the facility cannot meet under the criteria outlined in these regulations if not in conflict with …

A. Application for licensure, whether initial or renewal, shall constitute permission for entry into, and survey of, a facility by authorized licensing authority representatives at reasonable times during the status of the application and, if licensed, during the licensure period…

All facilities licensed pursuant to these regulations must report incidents in accordance with the policies established by the division of health improvement of the authority.

All facilities licensed pursuant to these regulations must be in compliance with the quality assurance standards established by the division of health improvement of the authority.

Each facility licensed pursuant to these regulations must maintain a record for each client in accordance with the client record standards set forth by the division of health improvement of the authority.

Each facility licensed pursuant to these regulations must keep the following reports and records on file and make them available for review upon request of the licensing authority: A. a copy of the latest fire inspection report by the fire authority having jurisdiction; B. a copy…

All facilities licensed pursuant to these regulations shall support, protect and enhance the rights of clients in accordance with the standards set forth by the division of health improvement of the authority.

Each facility licensed pursuant to these regulations must maintain a complete record on file for each staff member or volunteer working more than half-time. Staff records will be made available for review upon request of the licensing authority. A. Staff records will contain at l…

All community mental health centers licensed pursuant to these regulations must have written policies and procedures in accordance with the standards set forth by the division of health improvement of the authority.

A. New construction, additions and alterations: When construction of new buildings, additions, or alterations to existing buildings are contemplated, plans and specifications covering all portions of the work must be submitted to the licensing authority for plan review and approv…

The regulations set forth herein are promulgated pursuant to the general authority granted under Subsection E of Section 9-8-6 NMSA 1978; and the authority granted under Subsection D of Section 24-1-2, Subsection I of Section 24-1-3, and Section 24-1-5 of the Public Health Act, N…

Facilities must maintain the building(s) in good repair at all times. Such maintenance shall include, but is not limited to, the following: A. all electrical, mechanical, water supply, heating, fire protection, and sewage disposal systems must be maintained in a safe and function…

A. The facility must be kept free from offensive odors and accumulations of dirt, rubbish, dust, and safety hazards. B. Counseling/therapy rooms, waiting areas and other areas of daily usage must be cleaned as needed to maintain a clean and safe environment for the clients. C. Fl…

A. A facility licensed pursuant to these regulations must be provided with an adequate supply of water that is of a safe and sanitary quality suitable for domestic use. B. If the water supply is not obtained from an approved public system, the private water system must be inspect…

A. All sewage and liquid wastes must be disposed of into a municipal sewage system where such facilities are available. B. Where a municipal sewage system is not available, the system used must be inspected and approved by the New Mexico environment department or recognized local…

All current applicable requirement of state and local codes for fire prevention and safety must be met by the facility.

Each facility must request from the fire authority having jurisdiction an annual fire inspection. If the policy of the fire authority having jurisdiction does not provide for annual inspection of the facility, the facility must document the date the request was made and to whom. …

A. All staff of the facility must know the location of, and be instructed in, proper use of fire extinguishers and other procedures to be observed in case of fire or other emergencies. The facility should request the fire authority having jurisdiction to give periodic instruction…

Each facility must have a fire evacuation plan posted in each separate area of the building showing routes of evacuation in case of fire or other emergency.