Chapter 27 — Chapter 27

and conditions; sanctions. A. In addition to any other actions required or permitted by federal law or regulation, the authority shall impose a hold on state medicaid payments to a long-term care facility thirty days after the authority makes an on-site visit that the long-term c…

refunds; penalty. A. Medicaid payment for a medicaid-eligible patient shall be accepted by a medicaid-certified nursing facility from the first month of medicaid eligibility, regardless of whether the eligibility is retroactive. The nursing facility shall refund to the patient or…

A. The department shall provide for a statewide, managed care system to provide cost-efficient, preventive, primary and acute care for medicaid recipients by July 1, 1995. B. The managed care system shall ensure: (1) access to medically necessary services, particularly for medica…

conduct; enforcement. A. As used in this section: (1) "business" means a corporation, partnership, sole proprietorship, firm, organization or individual carrying on a business; (2) "authority" or "department" means the health care authority; (3) "employee" means a person who has …

In providing coverage for mammograms under the medicaid program, the department shall ensure that: A. patients will not be routinely solicited for mammograms; and that mammograms will only be performed based on nationally recognized standards; and B. any fee for service payment t…

For fiscal year 2001, the medicaid personal spending allowance shall be forty-five dollars ($45.00) per month for each eligible recipient. Thereafter, the medicaid personal spending allowance shall be increased at the beginning of each fiscal year by the annual percentage increas…

Any section of the NMSA 1978 relating to public assistance which is in conflict with the provisions of the federal act or the federal Food Stamp Act, as may be amended from time to time, and federal regulations issued pursuant thereto, shall be suspended in its operation if the a…

Regulations and standards of the board and department adopted prior to the effective date of the Public Assistance Act are continued in full force and effect, unless modified or revoked. History: 1953 Comp., § 13-17-17, enacted by Laws 1973, ch. 376, § 18.

A. The authority is designated as the state agency to cooperate with the federal government in the administration of the provisions of Title 1, Title 4, Parts 2 and 3 of Title 5 and Title 10 of the federal Social Security Act. The authority shall cooperate with the proper departm…

A. Subject to the availability of state funds, the authority may provide assistance to aged, blind or disabled persons in the amounts consistent with federal law to enable the state to be eligible for medicaid funding. Persons shall be determined to be aged, blind or disabled acc…

The authority is designated as the custodian of all money received by the state, which the authority is authorized to administer, from any appropriations made by the congress of the United States for the purpose of cooperating with the several states in the enforcement and admini…

As used in the Public Assistance Act: A. "authority" or "department" means the health care authority; B. "board" means the authority; C. "director" means the secretary; D. "local office" means the county or district office of the authority; E. "medicaid advisory committee" means …

Assistance granted under this act shall not be transferable or assignable, at law or in equity, and none of the money paid or payable under this act shall be subject to execution, levy, attachment, garnishment or other legal process, or to the operation of any bankruptcy or insol…

ANNOTATIONS Repeals. — Laws 1998, ch. 8, § 28 and Laws 1998, ch. 9, § 28 repealed 27-2-22 NMSA 1978, as enacted by Laws 1937, ch. 18, § 11h, relating to recovery from a recipient, effective February 18, 1998. For provisions of former section, see the 1997 NMSA 1978 on NMOneSource…

A. The income support division of the department shall make reasonable efforts to ascertain any legal liability of third parties who are or may be liable to pay all or part of the medical cost of injury, disease or disability of an applicant for or recipient of medical assistance…

health benefit plans; clauses to exclude medicaid coverage prohibited. No employee health benefit plan established under the Employee Retirement Income Security Act of 1974, 29 U.S.C. 1144, that provides payments for health care on behalf of individuals residing in the state shal…

The federal government shall be entitled to a share of any amounts recovered under the preceding two sections [27-2-22, 27-2-23 NMSA 1978] if required as a condition to federal financial participation. The federal government's share shall be limited to a percentage of the net rec…

A. On the death of: (1) a recipient of financial assistance under Section 27-2-6 [repealed] or 27-2- 7 NMSA 1978 or under the federal supplemental security income program; or (2) a person living in a nursing home or an intermediate care facility, the payment for whose care is mad…

funeral director. Should any funeral director accept payment from sources other than the income support division of the authority for burial of a deceased person for whom a claim for burial expenses has been made to the division, the funeral director shall immediately notify the …

A. The authority is designated as the single state agency for the enforcement of child and spousal support obligations pursuant to Title 4-D of the federal Social Security Act with the following duties and powers to: (1) establish the paternity of a child in the case of the child…

A. In cases where the authority has provided cash assistance to children in a household, the court shall award judgment in favor of the authority and against the noncustodial parents of the children for child support, calculated pursuant to Section 40- 4-11.1 NMSA 1978, for all m…

ANNOTATIONS Repeals. — Laws 1981, ch. 90, § 4 repealed 27-2-29 NMSA 1978, as enacted by Laws 1969, ch. 182, § 2, relating to procedure for the enforcement of support by the district attorney, effective March 21, 1981.

fund created. A. To make disbursements and distributions pursuant to this section, the "health care authority reimbursement suspense fund" is created in the state treasury. B. When pursuing a claim arising under Section 27-2-23 or 27-2-28 NMSA 1978, in addition to other available…

A. Consistent with the federal act and subject to the availability of federal and state funds, the board shall adopt a standard of need which shall establish a reasonable level of subsistence. B. Consistent with the federal act, the board shall define by regulation exempt and non…

The court in term time or judge in vacation may make and enforce by attachment or otherwise such order to restrain the use or disposition of the property of the defendant to provide for the support of the dependents during the pendency of the suit as in his discretion may seem ju…

Upon final hearing, judgment for the authority shall include all sums expended during the pendency of the action. When the authority recovers judgments under Chapter 27, Article 2 NMSA 1978, it may enforce, compromise or settle the judgments in any way considered by the authority…

All state, county and municipal agencies, departments, bureaus and divisions shall cooperate in the location of absent parents who are not fulfilling their obligation to support their children and shall on request supply the authority with all information on hand relative to the …

ANNOTATIONS Repeals. — Laws 1998, ch. 8, § 28 and Laws 1998, ch. 9, § 28 repealed 27-2-33 NMSA 1978, as enacted by Laws 1937, ch. 18, § 21, relating to method of handling funds, effective February 18, 1998. For provisions of former section, see the 1997 NMSA 1978 on NMOneSource.c…

All assistance granted under this act shall be deemed to be granted and to be held subject to the provisions of any amending or repealing act that may hereafter be passed, and no recipient shall have any claim for compensation, or otherwise, by reason of his assistance being affe…

Consistent with the federal act, a person is eligible for public assistance grants under the Public Assistance Act if: A. pursuant to Section 27-2-3 NMSA 1978, the total amount of the person's nonexempt income is less than the applicable standard of need; B. nonexempt specific an…

Sections 27-2-41 through 27-2-47 NMSA 1978 may be cited as the "Indigent Catastrophic Illness Hospital Funding Act". History: Laws 1990, ch. 93, § 1; 2024, ch. 39, § 83.

A. The legislature finds that twenty-five percent of New Mexicans have no health insurance. When such individuals suffer a catastrophic illness, the large hospital bills that are incurred can often result in indigency for that sick person and his family. B. The purpose of the Ind…

As used in the Indigent Catastrophic Illness Hospital Funding Act [27-2-41 to 27-2- 47 NMSA 1978]: A. "authority" or "department" means the health care authority; B. "fund" means the indigent catastrophic illness hospital fund; C. "hospital" means any general or special hospital …

The "indigent catastrophic illness hospital fund" is created as a nonreverting fund in the state treasury. Money in the fund is appropriated to the authority to reimburse hospitals for eligible claims for hospital charges incurred by medically indigent patients and for paying adm…

A. A hospital may submit eligible claims to the department on or before April 1 of each year for payment from the fund by June 30 of each year in an amount determined pursuant to this section. B. A claim submitted by a hospital for payment from the fund shall be deemed an eligibl…

A medically indigent patient's deductible shall be an amount determined by the hospital that the medically indigent patient is able to pay the hospital in monthly installments over an eighteen-month period. That determination shall be made pursuant to department rules and regulat…

The department shall adopt and promulgate by September 30, 1990 rules and regulations necessary to implement and administer the Indigent Catastrophic Illness Hospital Funding Act [27-2-41 to 27-2-47 NMSA 1978]. History: Laws 1990, ch. 93, § 7. ARTICLE 2A Medicaid Estate Recovery

The department shall establish a program of supplemental postnatal assistance for those developmentally or intellectually disabled persons who during pregnancy received temporary assistance for needy families but whose assistance was revoked upon relinquishment of the newly born …

ANNOTATIONS Repeals. — Laws 1998, ch. 8, § 28 and Laws 1998, ch. 9, § 28, repealed 27-2-6.2 NMSA 1978, enacted by Laws 1988, ch. 122, § 1, relating to public assistance, employment and training requirements, effective February 18, 1998. For provisions of former section, see the 1…

A. Subject to the availability of state funds, public assistance shall be provided under a general assistance program to or on behalf of eligible persons who: (1) are under eighteen years of age and meet all eligibility conditions for the New Mexico Works Act [27-2B-1 NMSA 1978] …

A recipient shall be provided with information about expiration of medicaid or general assistance benefits when the recipient or the recipient's guardian, custodian or other authorized representative files a request for such information with the human services department [health …

ANNOTATIONS Repeals. — Laws 1998, ch. 8, § 28 and Laws 1998, ch. 9, § 28 repealed 27-2-8 NMSA 1978, amended by Laws 1975, ch. 187, § 5, relating to granting of assistance, effective February 18, 1998. For provisions of former section, see the 1997 NMSA 1978 on NMOneSource.com.

A. Consistent with the federal act, the department shall provide necessary hospital care for recipients of public assistance other than those eligible under the general assistance program authorized by Section 10 [27-2-7 NMSA 1978] of the Public Assistance Act. The rate of paymen…

A. A shelter care supplement shall be provided to those persons who are recipients of supplemental security income under Title 16 of the federal Social Security Act and who reside in shelter care homes licensed by the authority. B. The authority is authorized to determine eligibi…

Chapter 27, Article 2A NMSA 1978 may be cited as the "Medicaid Estate Recovery Act". History: Laws 1994, ch. 87, § 1; 2024, ch. 39, § 86.

The purpose of the Medicaid Estate Recovery Act is to authorize and require the department to seek recovery of medical assistance payments made by the department for certain individuals, under certain circumstances, as provided in Title XIX of the Social Security Act. History: La…

As used in the Medicaid Estate Recovery Act: A. "authority" or "department" means the health care authority; B. "estate" means real and personal property and other assets of the individual subject to probate or administration pursuant to the provisions of the Uniform Probate Code…

payments restriction. A. The department shall seek recovery from the estate of an individual: (1) for medical assistance paid on behalf of an individual who was an inpatient in a nursing facility, intermediate care facility for individuals with developmental or intellectual disab…

A. The department shall administer the estate recovery program. B. The department shall adopt and promulgate rules and regulations to implement the provisions of the Medicaid Estate Recovery Act. C. The department may compromise, settle or waive recovery pursuant to the Medicaid …

The department shall waive the application of the provisions of the Medicaid Estate Recovery Act if application of the provisions would work an undue hardship as determined pursuant to regulations adopted and promulgated by the secretary of human services. The regulations shall i…