Chapter 27 — Chapter 27
284 sections in this chapter.
NMSA 1978, § 27-1-1 Definitions
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As used in Articles 1 and 2 of Chapter 13 NMSA 1953, "department", "department of public welfare", "state department of public welfare", "New Mexico department of public welfare", "state board of public welfare", "board of public welfare", "state board", "state department", "heal…
NMSA 1978, § 27-1-10 Collection and use of social security numbers for use in
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child support enforcement. A. For applicants or persons who have been assigned a social security number, the state shall have and use procedures requiring that the social security number of any: (1) applicant for a professional license, commercial driver's license or occupational…
NMSA 1978, § 27-1-11 Expedited procedure
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The state Title IV-D agency shall have the authority to take the following actions relating to establishment of paternity or to establishment, modification or enforcement of support orders, without the necessity of obtaining an order from any other judicial or administrative trib…
NMSA 1978, § 27-1-12 Work requirement for persons owing past-due child
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support. The state Title IV-D agency must have and use procedures under which the state has the authority, in any case in which an individual owes past-due support with respect to a child receiving assistance under a state program funded under temporary assistance for needy famil…
NMSA 1978, § 27-1-13 Financial institution data matches
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A. "Financial institution" means: (1) a depository institution, as defined in Section 3(c) of the Federal Deposit Insurance Act (12 U.S.C. 1813(c)); (2) an institution-affiliated party, as defined in Section 3(u) of that act (12 U.S.C. 1813(u)); (3) any federal credit union or st…
NMSA 1978, § 27-1-14 Enforcement of orders for health care
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A. All Title IV-D agency cases shall include a provision for the health care coverage of each child. In the case in which a medical support obligor parent provides such coverage and changes employment and the new employer provides such coverage, the state Title IV-D agency shall …
NMSA 1978, § 27-1-15 Repealed
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History: Laws 2005, ch. 160, § 1; repealed by Laws 2006, ch. 26, § 4.
NMSA 1978, § 27-1-16 Brain injury services fund created
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A. The "brain injury services fund" is created as a nonreverting fund in the state treasury. The fund shall be invested in accordance with the provisions of Section 6-10- 10 NMSA 1978, and all income earned on the fund shall be credited to the fund. B. The brain injury services f…
NMSA 1978, § 27-1-2 Powers of health care authority
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A. The health care authority is an agency of the state and shall at all times be under the exclusive control of this state. The management and control of the health care authority is vested in the secretary of health care authority. B. Subject to the constitution of New Mexico, t…
NMSA 1978, § 27-1-2.1 Temporary provision; subsidies to certain acute care
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facilities to cover revenue losses. (Repealed effective July 1, 2026.) A. An eligible health care facility may apply annually to the health care authority department for quarterly subsidies to provide to sick and indigent persons in New Mexico: (1) emergency medical services; (2)…
NMSA 1978, § 27-1-3 Activities of health care authority
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The health care authority shall be charged with the administration of all the welfare activities of the state as provided in Chapter 27 NMSA 1978, except as otherwise provided for by law. The health care authority shall, except as otherwise provided by law: A. administer old age …
NMSA 1978, § 27-1-3.1 Acute care bed usage; funding authorization
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The health care authority is authorized to accept and use federal grants or matching funds for the purpose of reimbursement to certain rural hospitals for using empty acute care beds for intermediate care and skilled nursing care, as defined in federal statutes and regulations, s…
NMSA 1978, § 27-1-4 Status of assistance payments
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Payments received by a displaced person under the Relocation Assistance Act [42- 3-1 NMSA 1978] shall not be considered as income or resources to any recipient of public assistance, and such payments shall not be deducted from the amount of aid to which the recipient would otherw…
NMSA 1978, § 27-1-8 State case registry
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A. The health care authority, acting as the state's child support enforcement agency pursuant to Title 4-D of the Social Security Act, shall establish a state case registry by October 1, 1998 that contains records with respect to: (1) each case in which services are being provide…
NMSA 1978, § 27-1-9 Locator information from interstate networks
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The state Title IV-D agency is authorized to have access to any system used by the state to locate an individual for purposes relating to motor vehicle or law enforcement. History: Laws 1997, ch. 237, § 14.
NMSA 1978, § 27-2-1 Short title
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Sections 27-2-1 through 27-2-34 NMSA 1978 may be cited as the "Public Assistance Act". History: 1953 Comp., § 13-17-1, enacted by Laws 1973, ch. 376, § 1; 2013, ch. 139, § 1.
NMSA 1978, § 27-2-10 Food stamp program
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The income support division of the human services department [health care authority department]: A. is authorized to establish a food stamp program to carry out the federal Food Stamp Act, as may be amended from time to time, and regulations issued pursuant to that act, subject t…
NMSA 1978, § 27-2-11 Scope of assistance programs
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Any public assistance program conducted by the department under the federal act is effective in all political subdivisions if the federal act so requires. History: 1953 Comp., § 13-17-14, enacted by Laws 1973, ch. 376, § 15.
NMSA 1978, § 27-2-12 Medical assistance programs
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A. Consistent with the federal act and subject to the appropriation and availability of federal and state funds, the medical assistance division of the department may by rule provide medical assistance, including the services of licensed doctors of oriental medicine, licensed chi…
NMSA 1978, § 27-2-12.1 Repealed
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ANNOTATIONS Repeals. — Laws 1979, ch. 330, § 1, repealed 27-2-12.1 NMSA 1978, enacted by Laws 1978, ch. 94, § 1, relating to medicaid institutional care computation.
NMSA 1978, § 27-2-12.10 Clinical nurse specialists
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The department shall recognize clinical nurse specialists as mid-level providers in the medicaid program provided that the clinical nurse specialists comply with the requirements for licensure pursuant to the Nursing Practice Act [Chapter 61, Article 3 NMSA 1978] and that the ser…
NMSA 1978, § 27-2-12.11 Prescription drug waiver program; purpose; eligibility
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Subject to the availability of state funds and consistent with the federal Social Security Act, the human services department [health care authority department] shall create a medicaid waiver program and may by regulation provide prescription drugs to persons whose incomes are le…
NMSA 1978, § 27-2-12.12 Human services department [health care authority
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department]; managed care contract credentialing provisions. The human services department [health care authority department] shall negotiate with medicaid contractors to ensure that the contractors' credentialing requirements are coordinated with other credentialing processes re…
NMSA 1978, § 27-2-12.13 Medicaid reform; program changes
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A. The department shall carry out the medicaid program changes as recommended by the medicaid reform committee that was established pursuant to Laws 2002, Chapter 96, as follows: (1) develop a uniform preferred drug list for the state's medicaid prescription drug benefit and inte…
NMSA 1978, § 27-2-12.14 Brain injury; services authorized
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Subject to the availability of state funds and consistent with Title 19 of the federal Social Security Act, the department shall provide services to persons with brain injuries, with emphasis on long-term disability services provided through home- and community- based programs. H…
NMSA 1978, § 27-2-12.15 Medicaid, state children's health insurance program and
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state coverage initiative program medical home waiver; rulemaking; application for waiver or state plan amendment. A. Subject to the availability of state funds and consistent with the federal Social Security Act, the department shall work with its contractors that administer the…
NMSA 1978, § 27-2-12.16 Medicaid recipients; cost-sharing payments for
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emergency medical services when non-emergency services are indicated. A. Consistent with the federal act and subject to the appropriation and availability of federal and state funds, the department shall promulgate rules that require a recipient who chooses a high-cost medical se…
NMSA 1978, § 27-2-12.17 Qualified state long-term care insurance partnership
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program; establishment; rulemaking. A. Consistent with the federal act and subject to the appropriation and availability of federal and state funds, the secretary shall amend the state medicaid plan to establish a qualified state long-term care insurance partnership program pursu…
NMSA 1978, § 27-2-12.18 Medical assistance; prescription drugs; prior
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authorization request form; prior authorization protocols. A. Beginning January 1, 2014, the department shall require its medicaid contractors to accept the uniform prior authorization form developed pursuant to Sections 2 [59A-2- 9.8 NMSA 1978] and 3 [61-11-6.2 NMSA 1978] of thi…
NMSA 1978, § 27-2-12.19 Former foster-care recipients; medical assistance
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coverage until age twenty-six. The department shall cover individuals who are residents of New Mexico and who are former recipients of foster care, regardless of the state where the foster care was received, until those individuals reach the age of twenty-six years. History: Laws…
NMSA 1978, § 27-2-12.2 Medical assistance program; eligibility of married
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individuals. For the purpose of determining medical assistance for institutional care program eligibility under the Public Assistance Act, the community spouse resource allowance for a community spouse as defined and authorized by the federal Medicare Catastrophic Coverage Act of…
NMSA 1978, § 27-2-12.20 Crisis triage center; medical assistance reimbursement
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A. In accordance with federal law, the secretary shall adopt and promulgate rules to establish a reimbursement rate for services provided to recipients of state medical assistance at a crisis triage center. B. As used in this section, "crisis triage center" means a health facilit…
NMSA 1978, § 27-2-12.21 Medical assistance; pharmacy benefits; prescription
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synchronization. A. In accordance with federal law, the secretary shall adopt and promulgate rules that allow a recipient to fill or refill a prescription for less than a thirty-day supply of a prescription drug and apply a prorated daily copayment or coinsurance, if applicable, …
NMSA 1978, § 27-2-12.22 Incarcerated persons; medicaid eligibility; county jail
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technical assistance; presumptive eligibility determiner training and certification. A. Incarceration shall not be a basis to deny or terminate eligibility for medicaid. B. Upon release from incarceration, a formerly incarcerated person shall remain eligible for medicaid until th…
NMSA 1978, § 27-2-12.23 Medical assistance; prescription drug coverage; step
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therapy protocols; clinical review criteria; exceptions. A. By January 1, 2019, the secretary shall require any medical assistance plan for which any step therapy protocols are required to establish clinical review criteria for those step therapy protocols. The clinical review cr…
NMSA 1978, § 27-2-12.24 Medical assistance; plan of care; participation required
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A. By January 1, 2020, the secretary shall require medical assistance plans to establish, in consultation with the department, hospitals, birthing centers, the children, youth and families department and the department of health, a process for the creation and implementation of a…
NMSA 1978, § 27-2-12.25 Prior authorization for gynecological or obstetrical
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ultrasounds prohibited. A. The department shall prohibit its medicaid managed care and fee-for-service contractors from requiring prior authorization for gynecological or obstetrical ultrasounds. B. Nothing in this section shall be construed to require payment for a gynecological…
NMSA 1978, § 27-2-12.26 Qualified medicare beneficiary recipients; medicare part
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B coverage automatic enrollment. A. The department shall provide for the automatic enrollment into medicare part B coverage of individuals: (1) whom it deems eligible for participating in the qualified medicare beneficiary program; and (2) who are not enrolled in medicare part B …
NMSA 1978, § 27-2-12.27 Medical assistance; managed care organization
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contracts; applicability of Prior Authorization Act. The secretary shall ensure that contracts with managed care organizations to provide medical assistance to medicaid recipients are subject to and comply with the Prior Authorization Act. History: Laws 2019, ch. 187, § 2.
NMSA 1978, § 27-2-12.28 Medical assistance; autism spectrum disorder
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A. The secretary shall ensure that medical assistance coverage provides coverage, which shall not be subject to age restrictions or dollar limits, for: (1) well-baby and well-child screening for diagnosing the presence of autism spectrum disorder; and (2) treatment of autism spec…
NMSA 1978, § 27-2-12.29 Medical assistance; reimbursement for a one-year
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supply of covered prescription contraceptive drugs or devices. A. In providing coverage for family planning services and supplies under the medical assistance program, the department shall ensure that a recipient is permitted to fill or refill a prescription for a one-year supply…
NMSA 1978, § 27-2-12.3 Medicaid reimbursement; equal pay for equal
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physicians', dentists', optometrists', podiatrists' and psychologists' services. The human services department [health care authority department] shall establish a rate for the reimbursement of physicians, dentists, optometrists, podiatrists and psychologists for services rendere…
NMSA 1978, § 27-2-12.30 Pharmacist prescriptive authority services;
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reimbursement parity. A medical assistance program or its contractor shall reimburse a participating provider that is a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service at the standard contracted rate that t…
NMSA 1978, § 27-2-12.31 Heart artery calcium scan coverage
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A. In accordance with federal law, the secretary shall adopt and promulgate rules that provide medical assistance coverage for eligible enrollees to receive a heart artery calcium scan. B. Medical assistance coverage provided pursuant to this section shall: (1) be limited to the …
NMSA 1978, § 27-2-12.32 Biomarker testing coverage
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A. In accordance with federal law, the secretary shall adopt and promulgate rules that provide medical assistance coverage for enrollees to receive biomarker testing. B. A medical assistance plan providing coverage pursuant to this section shall be for the purposes of diagnosis, …
NMSA 1978, § 27-2-12.33 Study of the medicaid forward plan
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A. The secretary, in coordination with the superintendent of insurance and in consultation with the medicaid advisory committee, other stakeholders identified by the secretary and representatives of Indian nations, tribes and pueblos that are located wholly or partially in New Me…
NMSA 1978, § 27-2-12.34 Community-based pharmacy reimbursement
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A. Each managed care organization that contracts with the department shall ensure that community-based pharmacy providers that provide services to medicaid recipients are reimbursed as follows: (1) for the ingredient cost of a drug at a value that is at least equal to the nationa…
NMSA 1978, § 27-2-12.35 Mi via waiver program; gross receipts taxes
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A. The health care authority shall promulgate rules to ensure that gross receipts taxes are not used to calculate the individual budgetary allotments for individuals participating in the mi via waiver program. A health care provider's costs for gross receipts taxes shall be bille…
NMSA 1978, § 27-2-12.36 Equitable reimbursement for services provided at birth
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centers. A. For the purposes of this section: (1) "birth center" means a freestanding birth center licensed by the state for the primary purpose of performing low-risk deliveries that is not a hospital, attached to a hospital or in a hospital and where births are planned to occur…
NMSA 1978, § 27-2-12.37 Reimbursement for gross receipts taxes
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A. When a health care provider contracts with a managed care organization for medicaid reimbursement for providing health care services to a recipient, the managed care organization shall: (1) reimburse the health care provider for all applicable gross receipts taxes that the hea…