reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.10 - RESOURCE STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The value of an applicant/recipient's individual countable
				  resources must not exceed the amount set forth in Section
				  8.200.510.14 NMAC, resource amounts
				  for supplemental security income (SSI) related medicare savings programs (QMB
				  and SLIMB/QI). The resource limit for an applicant couple is the amount set
				  forth in Section
				  8.200.510.14 NMAC. An
				  applicant/recipient with an ineligible spouse is eligible if the couple's
				  countable resources do not exceed the amount set forth in Section
				  8.200.510.14 NMAC, when resources
				  are deemed. The resource determination is always made as of the first moment of
				  the first day of the month. The applicant/recipient is ineligible for any month
				  in which the countable resources exceed the current resource standard as of the
				  first moment of the first day of the month. Changes in the amount of resources
				  during a month do not affect eligibility for that month. See Section
				  8.215.500.13 NMAC, countable
				  resources, and Section
				  8.215.500.14 NMAC, resource
				  exclusions, for specific information on exclusions, disregards, and calculation
				  of countable resources.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.11 - RESOURCE TRANSFERS

Current through Register Vol. 35, No. 13, July 16, 2024
The social security administration excluded transfer of
				  resources as a factor of eligibility for non-institutionalized SSI recipients.
				  Transfer of resources is not a factor for consideration in categories that use
				  SSI methodology in the eligibility determination.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.12 - TRUSTS

Current through Register Vol. 35, No. 13, July 16, 2024
See Section 8.281.510 NMAC and following
				  subsections.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.13 - INCOME STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The income ceiling for QMB eligibility is one hundred percent
				  of the federal income poverty guidelines. These guidelines are updated annually
				  effective April 1st. See Section 8.200.520 NMAC,
Income
				  Standards
. If the applicant is a minor child, income must be deemed
				  from the parent(s). Income must be verified and documented in the case record.
				  See Section
				  8.215.500.13 NMAC,
countable resources
, and Section
				  8.215.500.14 NMAC,
resource
				  exclusions
, for specific information on exclusions, disregards, and
				  calculation of countable income.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.14 - UNEARNED INCOME

Current through Register Vol. 35, No. 13, July 16, 2024
A. Unearned
				income exclusions: All social security and railroad retirement beneficiaries
				receive cost of living adjustments (COLAs) in January of each year. The ISD
				caseworker must disregard the COLA from January through March when
				(re)determining QMB eligibility. For redeterminations made in January, February
				and March and for new QMB applications registered in January, February or
				March, the ISD caseworker uses the December social security and railroad
				retirement benefit amounts. For QMB applications registered from April through
				December, total gross income including the new COLA figures are used to
				determine income and compared to the new April federal poverty levels. This
				exclusion does not apply to other types of income.
B. Evaluation of applicant/recipient's
				income: The ISD caseworker determines the amount of income available to the
				applicant/recipient using only the applicant/recipient's own income. A standard
				$20 disregard is allowed in accordance with Section
				8.215.500.22 NMAC. The federal
				poverty level standard disregard is only given if the applicant/recipient lives
				with an ineligible spouse. See Section
				8.240.500.15 NMAC for deemed
				income.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Health Care Authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
The New Mexico medicaid program is administered pursuant to
				  regulations promulgated by the federal department of health and human services
				  under Title XIX of the Social Security Act, as amended, and by the state health
				  care authority pursuant to state statute. See Section 27-2-12 et seq. NMSA 1978
				  (Repl. Pamp. 191991). Section 9-8-1 et seq. NMSA 1978 establishes the health
				  care authority (HCA) as a single, unified department to administer laws and
				  exercise functions relating to health care facility licensure and health care
				  purchasing and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 1, 2024, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of these regulations is to provide eligibility
				  policy and procedures for the medicaid program.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.9 - BENEFIT DESCRIPTION

Current through Register Vol. 35, No. 13, July 16, 2024
For qualified medicare beneficiaries (QMB), medicaid covers
				  payment of medicare premium amounts for Parts A and B and the coinsurance and
				  deductibles on medicare-covered services.
Medicaid does not pay for services which are not medicare
				  benefits, services denied by medicare, or services furnished by providers who
				  have not accepted medicare assignment. Reimbursement is made to providers of
				  covered services and not directly to recipients.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.10 - BENEFIT DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
Application for QMB is made on the assistance application
				  form. A separate application is not required if the recipient is receiving
				  medicaid under another category. The income support specialist (ISS) must act
				  on applications and send notice of action taken to the applicant within 45 days
				  after the date of application. After the eligibility determination is made,
				  notice of the approval or denial is sent to the applicant. If the application
				  is denied, this notice includes the reason for the denial and an explanation of
				  the recipient's right to a hearing
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.11 - INITIAL BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
Eligibility begins the month after the month the case is
				  approved. No retroactive coverage is available. Enrollment periods for medicare
				  coverage: Individuals who are not entitled to free medicare Part A can purchase
				  it. This is called "premium" or "conditional" Part A coverage. Applicants who
				  are entitled to free medicare Part A may apply for QMB at any time. Enrollment
				  for premium/conditional medicare Part A, is accepted by the social security
				  administration (SSA) once a year, from January through March, with coverage
				  starting in July. If a QMB applicant has an award letter or medicare card
				  showing premium/ conditional enrollment for July, the case can be approved in
				  June with coverage beginning in July.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.12 - ONGOING BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
A redetermination of eligibility conditions must be made at
				  least every 12 months but no more frequently than every six
				  months.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.13 - RETROACTIVE BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
No retroactive medicaid benefits are available for
				  applicants/recipients in this category.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 600 - BENEFIT DESCRIPTION › Section 8.240.600.14 - CHANGES IN ELIGIBILITY

Current through Register Vol. 35, No. 13, July 16, 2024
A case is closed when the recipient becomes ineligible, with
				  provision of advance notice. If a recipient dies, the case is closed the
				  following month.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Health Care Authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
The rule applies to the general public.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
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 1978.
				  Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as
				  a single, unified department to administer laws and exercise functions relating
				  to health care facility licensure and health care purchasing and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
January 1, 2014, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
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, 8.200 NMAC,
Medicaid
				  Eligibility - General Recipient Policies
. Processes for establishing
				  and maintaining medicaid eligibility are detailed in the income support
				  division (ISD) general provisions 8.100 NMAC,
General Provisions for
				  Public Assistance Programs
.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
[RESERVED]
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.8 - MISSION

Current through Register Vol. 35, No. 13, July 16, 2024
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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.9 - QUALIFIED DISABLED WORKING INDIVIDUALS (QD) - CATEGORY 050

Current through Register Vol. 35, No. 13, July 16, 2024
A. To qualify as a
				qualified disabled working individual (QD), an applicant or re-determining
				recipient must meet the following requirements:
(1) lose entitlement to free medicare Part A
				due to substantial gainful employment;
(2) continue to meet the social security
				administration (SSA) disability criteria; and
(3) be enrolled for premium Part A
				medicare.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.11 - ENUMERATION

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant or a re-determining recipient must have a social
				  security number. Refer to
				  8.200.410.10
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.12 - CITIZENSHIP

Current through Register Vol. 35, No. 13, July 16, 2024
Refer to
				  8.200.410.11
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.13 - RESIDENCE

Current through Register Vol. 35, No. 13, July 16, 2024
An individual must be either be physically present in New
				  Mexico on the date of his or her application or re-determination or on the
				  eligibility determination date and intend to remain in the state. A temporary
				  absence from the state does not preclude eligibility. A temporary absence is
				  considered to exist when the eligible recipient leaves the state for a specific
				  purpose with a time-limited goal, after accomplishment of which the eligible
				  recipient intends to return to New Mexico. Refer to
				  8.200.410.12
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.14 - NONCONCURRENT RECEIPT OF ASSISTANCE

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant or re-determining recipient is not eligible for
				  category 050 if he or she is eligible under another medical assistance division
				  (MAD) category of eligibility or if receiving medicaid services from another
				  state.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.16 - AGE

Current through Register Vol. 35, No. 13, July 16, 2024
A recipient must be under 65 years of age. When a recipient
				  reaches 65 years of age he or she becomes entitled to free medicare Part
				  A.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.17 - RECIPIENT RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
It is the responsibility of the applicant or re-determining
				  recipient to provide the required information, documents or undertake the
				  actions necessary for HSD to establish eligibility. The applicant or
				  re-determining recipient must grant HSD permission to contact other persons,
				  agencies or sources of information which are necessary in the establishment of
				  eligibility. Failure of the applicant or re-determining recipient to provide or
				  take action will result in an HSD action to deny eligibility. Refer to
				  8.200.430 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.18 - ASSIGNMENT OF SUPPORT

Current through Register Vol. 35, No. 13, July 16, 2024
Assignment of medical support rights is not a factor of
				  eligibility for this category, since medicaid coverage is limited to medicare
				  Part A premium.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 400 - RECIPIENT REQUIREMENTS › Section 8.242.400.19 - REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant, re-determining, or eligible recipient must
				  report any change in his or her circumstances which can affect his or her
				  eligibility within 10 calendar days after the change to his or her local income
				  support division (ISD) office. Refer to
				  8.200.430.19
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Health Care Authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
The rule applies to the general public.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
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 1978.
				  Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as
				  a single, unified department to administer laws and exercise functions relating
				  to health care facility licensure and health care purchasing and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.4 - DURATION

Current through Register Vol. 35, No. 13, July 16, 2024
Permanent.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
January 1, 2014, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
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, specifically
				  8.200.400 NMAC,
General Medicaid Eligibility
. Processes for
				  establishing and maintaining medical assistance eligibility are detailed in the
				  income support division (ISD) general provisions 8.100 NMAC,
General
				  Provisions for Public Assistance Programs
.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
[RESERVED]
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.8 - MISSION

Current through Register Vol. 35, No. 13, July 16, 2024
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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.9 - NEED DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant or a re-determining recipient for MAD
				  eligibility Category 050 qualified disabled individuals (QD) must apply for and
				  take all necessary actions to obtain any resources to which he or she may be
				  entitled. See 8.215.500 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.10 - RESOURCE STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The total value of an applicant or a re-determining
				  recipient's countable resources must not exceed $4,000. The resource limit for
				  an applicant or re-determining recipient couple is $6,000. An applicant or a
				  re-determining recipient with an ineligible spouse is eligible if the couple's
				  countable resources do not exceed $6,000 at the time resources are deemed. The
				  resource determination is always made as of the first moment of the first day
				  of the month. An applicant or a re-determining recipient is ineligible for any
				  month in which countable resources exceed the current resource standard as of
				  the first moment of the first day of the month. Changes in the value of
				  countable resources during a month do not affect eligibility for that
				  month.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.11 - RESOURCE TRANSFERS

Current through Register Vol. 35, No. 13, July 16, 2024
The social security administration (SSA) excluded transfer of
				  resources as a factor of eligibility for a non-institutionalized recipient who
				  receives supplemental security income (SSI) benefits. Transfer of resources is
				  not a factor for consideration in categories that use SSI methodology in the
				  eligibility determination.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.12 - INCOME STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The income ceiling for QD eligibility is 200 percent of the
				  federal income poverty (FPL) guidelines. These guidelines are updated annually
				  effective April 1. See 8.200.520 NMAC and 8.215.500 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.13 - UNEARNED INCOME

Current through Register Vol. 35, No. 13, July 16, 2024
Unearned income exclusions: All social security and railroad
				  retirement beneficiaries receive cost of living adjustments (COLAs) in January
				  of each year. The income support specialist (ISS) must disregard the COLA from
				  January through March when determining or re-determining QD eligibility. For
				  re-determinations made in January, February and March or new QD applications
				  registered in January, February or March, the ISS uses the December social
				  security and railroad retirement benefit amounts. For QD applications
				  registered from April through December, total gross income including the new
				  COLA figures are used to determine income and compared to the new April FPL.
				  This exclusion does not apply to other types of income.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.242.500.14 - DEEMED INCOME

Current through Register Vol. 35, No. 13, July 16, 2024
If an applicant or a re-determining recipient is married and
				  lives with a spouse, deemed income from the spouse must be considered. See
				  8.215.500 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Health Care Authority.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
The rule applies to the general public.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
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 1978.
				  Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as
				  a single, unified department to administer laws and exercise functions relating
				  to health care facility licensure and health care purchasing and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
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, specifically
				  8.200.400 NMAC,
General Medicaid Eligibility
. Processes for
				  establishing and maintaining MAD eligibility are detailed in the income support
				  division (ISD) general provisions 8.100 NMAC,
General Provisions for
				  Public Assistance Programs
.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.7 - DEFINITIONS: [RESERVED]

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.9 - BENEFIT DESCRIPTION

Current through Register Vol. 35, No. 13, July 16, 2024
For Category 050, medicaid coverage is limited to payment of
				  the medicare Part A premium. No medicaid card is issued.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.10 - BENEFIT DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
Application for Category 050 is made on the assistance
				  application form. Applications must be acted on and notice of action taken must
				  be sent to the applicant within 45 days of receipt of the
				  application.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.11 - INITIAL BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
The effective date of eligibility for qualified disabled
				  working individuals (QD) is based on the date of application and the date on
				  which all eligibility criteria, including enrollment for medicare Part A, are
				  met. Verification of the effective date of medicare Part A enrollment must be
				  obtained from the social security administration (SSA). When the eligibility
				  determination is made, notice of the approval or denial is sent to the
				  applicant. If denied, this notice includes the reason for the denial and an
				  explanation of rights to a hearing.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.12 - ONGOING BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
A redetermination of eligibility must be made every 12
				  months.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.13 - RETROACTIVE BENEFIT COVERAGE

Current through Register Vol. 35, No. 13, July 16, 2024
Retroactive medicaid coverage is provided in accordance with
				  8.200.400.14
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 242 - MEDICAL ASSISTANCE PROGRAM ELIGIBILITY - QUALIFIED DISABLED INDIVIDUALS WHOSE INCOME EXCEEDS QMB AND SLIMB › Part 600 - BENEFIT DESCRIPTION › Section 8.242.600.14 - CHANGES IN ELIGIBILITY

Current through Register Vol. 35, No. 13, July 16, 2024
The case is closed when an eligible recipient becomes
				  ineligible and is notified of the ineligibility in an advance notice. The case
				  is closed in the month following the death of an eligible
				  recipient.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
The New Mexico medicaid program is administered pursuant to
				  regulations promulgated by the federal department of health and human services
				  under Title XIX of the Social Security Act, as amended by the state human
				  services department pursuant to state statute. See 27-2-12 et. seq., NMSA 1978
				  (Repl. Pamp. 1991). Section 9-8-1 et seq. NMSA 1978 establishes the health care
				  authority (HCA) as a single, unified department to administer laws and exercise
				  functions relating to health care facility licensure and health care purchasing
				  and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of these regulations is to provide eligibility
				  policy and procedures for the medicaid program.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.8 - MISSION

Current through Register Vol. 35, No. 13, July 16, 2024
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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.9 - WORKING DISABLED INDIVIDUALS (WDI) - CATEGORY 043

Current through Register Vol. 35, No. 13, July 16, 2024
The working disabled individuals program covers:
A. disabled individuals who are employed;
				or
B. disabled individuals who have
				lost eligibility for supplemental security income (SSI) and medicaid due to
				initial receipt of social security disability insurance ( SSDI) and who are not
				yet qualified for medicare; this group is referred to as "medigap"; once the
				medigap individual begins receiving medicare, they must become employed, as
				defined in Paragraph (1) of Subsection C of
				8.243.400.10
				NMAC, to retain their eligibility for WDI.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.10 - BASIS FOR DEFINING THE GROUP

Current through Register Vol. 35, No. 13, July 16, 2024
Individuals eligible for medicaid coverage under the working
				  disabled individuals program (WDI) must meet the following requirements:
A. must meet the social security
				administration disability criteria without regard to "substantial gainful
				activity", and
B. must have a
				recent attachment to the workforce.
C.
Recent attachment to workforce
				defined:
Medicaid for the working disabled individuals defines recent
				attachment to the workforce as either:
(1)
				having enough gross earnings in a quarter to meet social security
				administration's definition of a qualifying quarter, see
				8.200.520.20
				NMAC; or
(2) having lost SSI and
				medicaid due to the initial receipt of SSDI benefits, and being within the
				24-month waiting period for medicare.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.12 - ENUMERATION

Current through Register Vol. 35, No. 13, July 16, 2024
To be eligible an individual must report their social
				  security account number(s) to the human services department (HSD). If an
				  individual does not have a valid social security number, the individual must
				  apply for one as a condition of medicaid eligibility. Applications for social
				  security numbers can be made by completing an application form, and providing
				  proof of application to local Income support division (ISD)
				  offices.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.13 - CITIZENSHIP

Current through Register Vol. 35, No. 13, July 16, 2024
To be eligible for medicaid, an individual must be:
A. a citizen of the United States;
				or
B. a non-citizen who entered the
				United States prior to August 22, 1996, as one of the classes of non-citizens
				described in Subsection A of 8.200.410.11 NMAC, or a non-citizen who entered
				the United States as a qualified non-citizen on or after August 22, 1996, and
				who has met the five-year bar, or are exempt as listed in Subsection B of
				8.200.410.11 NMAC.
C. Refer to
				8.200.410.11 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.14 - RESIDENCE

Current through Register Vol. 35, No. 13, July 16, 2024
To be eligible for medicaid, individuals must be living in
				  New Mexico on the date of application or final determination of eligibility and
				  have demonstrated intent to remain in the state.
A.
Establishing residence:
Residence in New Mexico is established by living in the state and carrying out
				the types of activities normally indicating residency, such as occupying a
				home, enrolling child(ren) in school, getting a state driver's license, or
				renting a post office box. An individual who is homeless is considered to have
				met the residence requirements if the individual intends to remain in the
				state.
B.
Recipients
				receiving benefits out-of-state:
Individuals who receive medical
				assistance in another state are considered residents of that state until the
				ISD staff receives verification from the other state agency indicating that it
				has been notified by an individual of the abandonment of residence in that
				state.
C.
Abandonment:
Residence is not abandoned by temporary absences. Temporary absences occur when
				recipients leave New Mexico for specific purposes with time-limited goals.
				Residence is considered abandoned when any of the following occurs:
(1) the individual leaves New Mexico and
				indicates that they intend to establish residence in another state;
(2) the individual leaves New Mexico for no
				specific purpose with no clear intention of returning;
(3) the individual leaves New Mexico and
				applies for financial, food or medical assistance in another state.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.15 - NON-CONCURRENT RECEIPT OF ASSISTANCE

Current through Register Vol. 35, No. 13, July 16, 2024
The individual may not be receiving assistance in another
				  medicaid category with the exception of the qualified medicare beneficiaries
				  (QMB) and specified low income medicare beneficiaries (SLIMB) programs. ISD
				  staff will look at other categories of eligibility and make the appropriate
				  eligibility determination, or referrals.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.16 - AGE

Current through Register Vol. 35, No. 13, July 16, 2024
The individual must be 18 years of age or
				  older.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.17 - DISABILITY

Current through Register Vol. 35, No. 13, July 16, 2024
The individual must meet social security administration's
				  disability or blindness criteria, without regard to "substantial gainful
				  activity".
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.18 - RECIPIENT RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
The individual is responsible for establishing their
				  eligibility for medicaid. As part of this responsibility, the individual must
				  provide required information and documents or take the actions necessary to
				  establish eligibility. Failure to do so must result in a decision that
				  eligibility does not exist. The individual must also grant the human services
				  department (HSD) permission to contact other persons, agencies or sources of
				  information which are necessary to establish eligibility.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.19 - ASSIGNMENT OF MEDICAL SUPPORT

Current through Register Vol. 35, No. 13, July 16, 2024
The individual must assign their right to medical support or
				  other third party payments to the state.
A. Assignment of medical support rights
				occurs through the application for medicaid benefits.
B. Medicaid is not denied to an otherwise
				eligible individual solely because they cannot legally assign their own medical
				support rights and the party who is legally able to assign those rights refuses
				to assign or cooperate, as required by law.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 400 - RECIPIENT POLICIES › Section 8.243.400.20 - REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant/recipient is responsible to report changes
				  affecting eligibility by the end of the calendar quarter in which the change
				  took place.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.243.500.1 - ISSUING AGENCY

Current through Register Vol. 35, No. 13, July 16, 2024
New Mexico Health Care Authority (HCA).
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.243.500.2 - SCOPE

Current through Register Vol. 35, No. 13, July 16, 2024
This rule applies to the general public.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.243.500.3 - STATUTORY AUTHORITY

Current through Register Vol. 35, No. 13, July 16, 2024
The New Mexico medicaid program is administered pursuant to
				  regulations promulgated by the federal department of health and human services
				  under Title XIX of the Social Security Act, as amended by the state health care
				  authority pursuant to state statute. See Section 27-2-12 et. seq. NMSA 1978
				  (Repl. Pamp. 1991). Section 9-8-1 et seq. NMSA 1978 establishes the health care
				  authority (HCA) as a single, unified department to administer laws and exercise
				  functions relating to health care facility licensure and health care purchasing
				  and regulation.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.243.500.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
January 1, 2001, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.243.500.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of these regulations is to provide eligibility
				  policy and procedures for the medicaid program.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 243 - MEDICAID ELIGIBILITY - WORKING DISABLED INDIVIDUALS (WDI) (CATEGORY 043) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.243.500.9 - WORKING DISABLED INDIVIDUALS

Current through Register Vol. 35, No. 13, July 16, 2024
Income and resources are determined based on SSI methodology,
				  except when deeming income from an ineligible spouse. See 8.215.500 NMAC.
				  Individuals must meet all financial and non-financial eligibility criteria in
				  the month(s) for which a determination of eligibility is
				  made.