reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.13 - ASSIGNMENT OF SUPPORT

Current through Register Vol. 35, No. 13, July 16, 2024
As a condition of MAP eligibility, HSD requires an applicant
				  or a re-determining eligible recipient to assign his or her medical care
				  support rights to HSD for medical support and any third party payments. The
				  assignment authorizes HSD to pursue and make recoveries from liable third
				  parties (
				  42 CFR
				  433.146; NMSA 1978 27-2-28(G) ).
A.
Assigning medical support
				rights:
The assignment to HSD of an eligible recipient's rights to
				medical support and payments occurs automatically under New Mexico law when the
				applicant or the re-determining eligible recipient signs the application.
B.
Third party liability (TPL):
This section
				  describes HSD's responsibility to identify and collect from primarily
				  responsible third parties and the eligible recipient's responsibility to
				  cooperate with HSD to uncover such payments. MAD is the payer of last resort.
				  If other third party resources are available, these health care resources must
				  be used before MAD makes a reimbursement. As a condition of MAP eligibility, an
				  applicant assigns his or her rights to physical and behavioral health support
				  and payments to HSD and promises to cooperate in identifying, pursuing, and
				  collecting payments from these resources. Third party resources include the
				  gross recovery by eligible recipient, including personal injury protection
				  benefits, before any reduction in attorney's fees or costs, obtained through
				  settlement or verdict, for personal injury negligence or intentional tort
				  claims or actions, up to the full amount of MAD payments for treatment of
				  injuries causally related to the occurrence that is the subject of the claim or
				  action.
(1) Required TPL information:
				During the initial determination or re-determination of eligibility for MAP
				enrollment, ISD must obtain information about TPL from either the applicant or
				the re-determining eligible recipient.
(a) HSD
				is required to take all reasonable measures to determine the legal liability of
				third parties, including health insurers in paying for the physical and
				behavioral health services furnished to an eligible recipient (
				42 CFR
				433.138(a) ).
(b) HSD uses the information collected at the
				time of determination in order for MAD to pursue claims against third
				parties.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.14 - ELIGIBLE RECIPIENT RESPONSIBILITY TO COOPERATE WITH ASSIGNMENT OF SUPPORT RIGHTS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Cooperation:
As a condition of MAP eligibility, an applicant or an
				eligible recipient must cooperate with HSD to:
(1) obtain physical and behavioral health
				support and payments for his or herself and other individuals for whom he or
				she can legally assign rights;
(2)
				pursue liable third parties by identifying individuals and providing
				information to HSD;
(3) cooperate
				with CSED to establish paternity and medical support as appropriate, see
				8.50.105.12 NMAC;
(4) appear at a
				state or local office designated by HSD to give information or evidence
				relevant to the case, appear as a witness at a court or other proceeding or
				give information or attest to lack of information, under penalty of
				perjury;
(5) refund HSD any money
				received for physical or behavioral health care that has already been paid;
				this includes payments received from insurance companies, personal injury
				settlements, and any other liable third party; and
(6) respond to the trauma inquiry letter that
				is mailed to an eligible recipient (
				42 CFR
				433.138(4) ); the letter
				asks an eligible recipient to provide more information about possible
				accidents, causes of accidents, and whether legal counsel has been obtained (
				42
				CFR 433.147; 45 CFR 232.42, 232.43; NMSA 1978
				27-2-28(G)(3) ).
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.15 - ELIGIBLE RECIPIENT RESPONSIBILITY TO GIVE PROVIDER PROPER IDENTIFICATION AND NOTICE OF ELIGIBILITY CHANGES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				An eligible recipient is responsible for presenting a current MAP eligibility
				card and evidence of any other health insurance to a MAD provider each time
				service is requested.
(1) An eligible
				recipient is responsible for any financial liability incurred if he or she
				fails to furnish current MAP eligibility identification before the receipt of a
				service and as a result the provider fails to adhere to MAD rules, such as a
				failure to request prior approval. If this omission occurs, the settlement of
				claims for services is between the eligible recipient and the provider. An
				individual is financially responsible for services received if he or she was
				not eligible for MAD services on the date services are furnished.
(2) When a provider bills MAD and the claim
				is denied, the provider cannot bill the eligible recipient. Exceptions exist
				for denials caused by MAP ineligibility or by an eligible recipient's failure
				to furnish MAP identification in a timely manner.
(3) If an eligible recipient fails to notify
				the provider that he or she has received services that are limited by time or
				amount, the eligible recipient is responsible for payment of the service prior
				to rendering the service if the provider made reasonable efforts to verify
				whether the eligible recipient has already received services.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.16 - ELIGIBLE RECIPIENT FINANCIAL RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
A. A MAD provider agrees to accept the amount
				paid as payment in full. A provider cannot bill an eligible recipient for any
				unpaid portion of the bill (balance billing) or for a claim that is not paid
				because of a provider administrative error or failure of multiple providers to
				communicate eligibility information.
(1) An
				eligible recipient is responsible for any financial liability incurred if he or
				she fails to furnish current MAP eligibility identification before the receipt
				of a MAP service and as a result the provider fails to adhere to MAD
				reimbursement rules, such as a failure to request prior approval. If this
				omission occurs, the settlement of claims for services is between the eligible
				recipient and the MAP provider. An individual is financially responsible for
				services received if he or she was not eligible for MAD services on the date
				services are furnished.
(2) When a
				provider bills MAD and the claim is denied, the provider cannot bill the
				eligible recipient. Exceptions exist for denials caused by MAP ineligibility or
				by an eligible recipient's failure to furnish MAP identification at the time of
				service.
(3) If an eligible
				recipient fails to notify a provider that he or she has received services that
				are limited by time or amount, the eligible recipient is responsible to pay for
				services if, before furnishing the services, the provider makes reasonable
				efforts to verify whether the eligible recipient has already received
				services.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.17 - RESTITUTION

Current through Register Vol. 35, No. 13, July 16, 2024
A. A MAP eligible
				recipient must return overpayments or medical payments received from liable
				third parties to the applicable medical service provider or to MAD. If payments
				are not returned or received, recoupment proceedings against the eligible
				recipient will be initiated.
B. The
				restitution bureau of HSD is responsible for the tracking and collection of
				overpayments made to MAP eligible recipients, vendors, and MAD providers. See
				Section OIG-940, RESTITUTIONS. The MAD third party liability unit is
				responsible for monitoring and collecting payments received from liable third
				parties. See 8.302.3 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.18 - REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A medicaid eligible recipient is required to report certain
				  changes which might affect his or her eligibility to ISD within 10 calendar
				  days from the date the change occurred. A timely change that is reported within
				  10 calendar days that may result in a more beneficial medicaid eligibility
				  category shall be evaluated in the month the change occurred. An untimely
				  change that is reported after 10 calendar days that may result in a more
				  beneficial medicaid eligibility category shall be evaluated in the month the
				  change was reported. A reported change that does not result in the same or a
				  more beneficial medicaid category is considered an adverse action and is
				  applied prospectively in accordance with
				  8.100.180.10
				  NMAC. See
				  8.100.110.9
				  NMAC for the various ways applicants and recipients can submit changes to the
				  HSD. The following changes must be reported to ISD:
A.
Living arrangements or change of
				address
: Any change in where an eligible recipient lives or gets his or
				her mail must be reported.
B.
Household size:
Any change in the household size must be reported.
				This includes the death of an individual included in the either or both the
				assistance unit and budget group.
C.
Enumeration:
Any new social
				security number must be reported.
D.
Income:
Except for continuous
				eligibility in 8.200.400 NMAC any increase or decrease in the amount of income
				or change in the source of income must be reported.
E.
Resource:
Resources only
				apply to non-modified adjusted gross income (MAGI) medicaid categories. Any
				change in what an eligible recipient owns must be reported. This includes any
				property the eligible recipient owns or has interest in, cash on hand, money in
				banks or credit unions, stocks, bonds, life insurance policies or any other
				item of value.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.19 - MAD ESTATE RECOVERY

Current through Register Vol. 35, No. 13, July 16, 2024
HSD is mandated to seek recovery from the estates of certain
				  individuals up to the amount of medical assistance payments made by the HSD on
				  behalf of the individual. See Social Security Act Section 1917 (
				  42 USC
				  1396 p(b) and NMSA 1978, Section
				  27-2A-1 et
				  seq. "Medicaid Estate Recovery Act").
A.
Definitions used in MAD estate
				recovery:
(1) Authorized
				representative: The individual designated to represent and act on the eligible
				recipient's behalf. The eligible recipient or authorized representative must
				provide formal documentation authorizing the named individual or individuals to
				access the identified case information for a specified purpose and time frame.
				An authorized representative may be an attorney representing a person or
				household, a person acting under the authority of a valid power of attorney, a
				guardian, or any other individual or individuals designated in writing by the
				member.
(2) Estate: Real and
				personal property and other assets of an individual subject to probate or
				administration pursuant to the New Mexico Uniform Probate Code.
(3) Medical assistance: Amounts paid by HSD
				for long term care services including related hospital and prescription drug
				services.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES › Section 8.200.430.20 - MAD ESTATE RECOVERY

Current through Register Vol. 35, No. 13, July 16, 2024
HSD is mandated to seek recovery from the estates of certain
				  individuals up to the amount of medical assistance payments made by the HSD on
				  behalf of the individual. See Social Security Act Section 1917 [
				  42 USC
				  1396 p(b) and NMSA 1978, Section
				  27-2A-1 et
				  seq. "Medicaid Estate Recovery Act"].
A.
Definitions used in MAD estate
				recovery:
(1) Estate: Real and personal
				property and other assets of an individual subject to probate or administration
				pursuant to the New Mexico Uniform Probate Code.
(2) Medical assistance: Amounts paid by HSD
				for long term care services including related hospital and prescription drug
				services.
(3) Personal
				representative: An adult designated in writing who is authorized to represent
				the estate of the eligible recipient.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 450 - REPORTING REQUIREMENTS › Section 8.200.450.3 - 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 NMSA 1978 et.
				  seq. (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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 450 - REPORTING REQUIREMENTS › Section 8.200.450.5 - 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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 450 - REPORTING REQUIREMENTS › Section 8.200.450.6 - 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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 450 - REPORTING REQUIREMENTS › Section 8.200.450.8 - MISSION

Current through Register Vol. 35, No. 13, July 16, 2024
To reduce the impact of poverty on people living in New
				  Mexico and to assure low income and disabled individuals in New Mexico equal
				  participation in the life of their communities.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 450 - REPORTING REQUIREMENTS › Section 8.200.450.9 - REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A medicaid applicant/recipient must report any change in
				  circumstances which might affect their eligibility within 10 days after the
				  change to the local income support division (ISD) office. This provision does
				  not apply to children's medicaid (category of eligibility 032). See
				  8.232.600.14 NMAC,
changes
				  in eligibility
.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.3 - 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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
July 1, 2015, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.6 - 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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.8 - MISSION STATEMENT

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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.9 - GENERAL NEED DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
To be eligible for medical assistance division (MAD)
				  benefits, an applicant or recipient must meet specific resource and income
				  standards based on eligibility category.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.10 - RESOURCE STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
For specific information on liquid, non-liquid and countable
				  resources, resource exclusions, deemed resources, resource transfers or trusts
				  see specific medical assistance programs (MAP) eligibility categories.
				  Standards for community spouse resource allowance, medical care credit
				  calculations and average cost for nursing facility care are included in this
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.12 - POST-ELIGIBILITY CALCULATION (MEDICAL CARE CREDIT)

Current through Register Vol. 35, No. 13, July 16, 2024
Apply applicable deductions in the order listed below when
				  determining the medical care credit for an institutionalized spouse.
DEDUCTION
AMOUNT
A.
Personal needs allowance for
								institutionalized spouse:
July 1, 2023
$91
B.
Minimum monthly maintenance needs
								allowance (MMMNA):
July 1, 2023
$2,465
C. The
				community spouse monthly income allowance (CSMIA) is calculated by subtracting
				the community spouse's gross income from the MMMNA:
(1) If allowable shelter expenses of the
				community spouse exceeds the minimum allowance then deduct an excess shelter
				allowance from community spouse's income that includes: expenses for rent;
				mortgage (including interest and principal); taxes and insurance; any
				maintenance charge for a condominium or cooperative; and an amount for
				utilities (if not part of maintenance charge above; use the standard utility
				allowance (SUA) deduction used in the food stamp program for the utility
				allowance.
July 1, 2023
$740
(2)
				Excess shelter allowance may not exceed the maximum:
(a)
Jan. 1, 2024
$1,388.50
(b)
July 1, 2023
$1,251
(c)
Jan. 1, 2023
$1,427
(d)
July 1, 2022
$1,146
(e)
Jan. 1, 2022
$1,257
(f)
July 1, 2021
$1,082
(g)
Jan. 1, 2021
$1,105
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.13 - AVERAGE MONTHLY COST OF NURSING FACILITIES FOR PRIVATE PATIENTS USED IN TRANSFER OF ASSET PROVISIONS

Current through Register Vol. 35, No. 13, July 16, 2024
Costs of care are based on the date of application
				  registration.
DATE
AVERAGE COST PER MONTH
A.
July 1, 1988 - Dec. 31, 1989
$1,726 per month
B.
Jan. 1, 1990 - Dec. 31, 1991
$2,004 per month
C.
Jan. 1, 1992 - Dec. 31, 1992
$2,217 per month
D.
Effective July 1, 1993, for application register
								on or after Jan. 1, 1993
$2,377 per month
E.
Jan. 1, 1994 - Dec. 31, 1994
$2,513 per month
F.
Jan. 1, 1995 - Dec. 31, 1995
$2,592 per month
G.
Jan. 1, 1996 - Dec. 31, 1996
$2,738 per month
H.
Jan. 1, 1997 - Dec. 31, 1997
$2,889 per month
I.
Jan. 1, 1998 - Dec 31, 1998
$3,119 per month
J.
Jan. 1, 1999 - Dec. 31, 1999
$3,429 per month
K.
Jan. 1, 2000 - Dec. 31, 2000
$3,494 per month
L.
Jan. 1, 2001 - Dec. 31, 2001
$3,550 per month
M.
Jan. 1, 2002 - Dec. 31, 2002
$3,643 per month
N.
Jan. 1, 2003 - Dec. 31, 2003
$4,188 per month
O.
Jan. 1, 2004 - Dec. 31, 2004
$3,899 per month
P.
Jan. 1, 2005 - Dec. 31, 2005
$4,277 per month
Q.
Jan. 1, 2006 - Dec. 31, 2006
$4,541 per month
R.
Jan. 1, 2007 - Dec. 31, 2007
$4,551 per month
S.
Jan. 1, 2008 - Dec. 31, 2008
$4,821 per month
T.
Jan. 1, 2009 - Dec. 31, 2009
$5,037 per month
U.
Jan. 1, 2010 - Dec. 31, 2010
$5,269 per month
V.
Jan. 1, 2011 - Dec. 31, 2011
$5,774 per month
W.
Jan. 1, 2012 - Dec. 31, 2012
$6,015 per month
X.
Jan. 1, 2013 - Dec. 31, 2013
$6,291 per month
Y.
Jan. 1, 2014 - Dec. 31, 2014
$6,229 per month
Z.
Jan. 1, 2015 - Dec. 31, 2015
$6,659 per month
AA.
Jan. 1, 2016 - Dec. 31, 2016
$7,786 per month
BB.
Jan. 1, 2017 - Dec. 31, 2017
$7,485 per month
CC.
Jan. 1, 2018 - Dec. 31, 2018
$7,025 per month
DD.
Jan. 1, 2019 - Dec. 31, 2019
$7,285 per month
EE.
Jan. 1, 2020 - Dec. 31, 2020
$7,480 per month
FF.
Jan. 1, 2021 - Dec. 31, 2021
$7,590 per month
GG.
Jan. 1, 2022 - Dec. 31, 2021
$7,811 per month
HH.
Jan. 1, 2023 - Dec. 31, 2023
$8,275 per month
II.
Jan. 1, 2024 -
$8,919 per month
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 510 - RESOURCE STANDARDS › Section 8.200.510.15 - EXCESS HOME EQUITY AMOUNT FOR LONG-TERM CARE SERVICES

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Jan. 2024
$713,000
B.
Jan. 2023
$688,000
C.
Jan. 2022
$636,000
D.
Jan. 2021
$603,000
E.
Jan. 2020
$595,000
F.
Jan. 2019
$585,000
G.
Jan. 2018
$572,000
H.
Oct. 2017
$560,000
I.
Jan. 2017
$840,000
J.
Jan. 2016
$828,000
K.
Jan. 2015
$828,000
L.
Jan. 2014
$814,000
M.
Jan. 2013
$802,000
N.
Jan. 2012
$786,000
O.
Jan. 2011
$758,000
P.
Jan. 2010
$750,000
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.3 - 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.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
August 28, 2015, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.6 - 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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.8 - MISSION STATEMENT

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 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.9 - GENERAL NEED DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
To be medical assistance division (MAD) eligible, an
				  applicant or a re-determining eligible recipient must meet specific income and
				  as applicable, resource standards.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.10 - INCOME STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
This part contains the federal income poverty rate tables for
				  use with all eligibility categories, cost of living (COLA) disregard
				  calculations and other applicable income tables.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.11 - FEDERAL POVERTY INCOME GUIDELINES

Current through Register Vol. 35, No. 13, July 16, 2024
A. One hundred percent federal poverty limits
				(FPL):
Size of budget group
FPL per month
1
$1,255*
2
$1,704*
3
$2,152
4
$2,600
5
$3,049
6
$3,497
7
$3,945
8
$4,394
Add $449 for each additional person in the budget
				  group.
*FPL must be below 100% for an individual or couple for
				  qualified medicare beneficiary (QMB) program.
B. One hundred twenty percent FPL: This
				income level is used only in the determination of the maximum income limit for
				specified low income medicare beneficiaries (SLIMB) applicants or eligible
				recipients.
Applicant or eligible recipient
Amount
1
Individual
At least $1,255 per month but no more than $1,506
								per month.
2
Couple
At least $1,704 per month but no more than $2,044
								per month.
For purposes of this eligibility calculation, "couple" means
				  an applicant couple or an applicant with an ineligible spouse when income is
				  deemed.
C. One hundred
				thirty-three percent FPL:
Size of budget group
FPL per month
1
$1,670
2
$2,266
3
$2,862
4
$3,458
5
$4,055
6
$4,651
7
$5,247
8
$5,844
Add $597 for each additional person in the budget
				  group.
D. One hundred
				thirty-five percent FPL: This income level is used only in the determination of
				the maximum income limit for a qualified individual 1 (QI1) applicant or
				eligible recipient. For purposes of this eligibility calculation, "couple"
				means an applicant couple or an applicant with an ineligible spouse when income
				is deemed. The following income levels apply:
Applicant or eligible recipient
Amount
1
Individual
At least $1,506 per month but no more than $1,695
								per month.
2
Couple
At least $2,044 per month but no more than $2,300
								per month.
E.
				One hundred eighty-five percent FPL:
Size of budget group
FPL per month
1
$2,322
2
$3,152
3
$3,981
4
$4,810
5
$5,640
6
$6,469
7
$7,299
8
$8,128
Add $829 for each additional person in the budget
				  group.
F. Two hundred
				percent FPL:
Size of budget group
FPL per month
1
$2,510
2
$3,407
3
$4,304
4
$5,200
5
$6,097
6
$6,994
7
$7,890
8
$8,787
Add $897 for each additional person in the budget
				  group.
G. Two hundred
				thirty-five percent FPL:
Size of budget group
FPL per month
1
$2,950
2
$4,003
3
$5,057
4
$6,110
5
$7,164
6
$8,218
7
$9,271
8
$10,325
Add $1,054 for each additional person in the budget
				  group.
H. Two hundred fifty
				percent FPL:
Size of budget group
FPL per month
1
$3,138
2
$4,259
3
$5,380
4
$6,500
5
$7,621
6
$8,742
7
$9,863
8
$10,984
Add $1,121 for each additional person in the budget
				  group.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.12 - COST OF LIVING ADJUSTMENT (COLA) DISREGARD COMPUTATION

Current through Register Vol. 35, No. 13, July 16, 2024
The countable social security benefit without the COLA is
				  calculated using the COLA increase table as follows:
A. divide the current gross social security
				benefit by the COLA increase in the most current year; the result is the social
				security benefit before the COLA increase;
B. divide the result from Subsection A above
				by the COLA increase from the previous period or year; the result is the social
				security benefit before the increase for that period or year; and
C. repeat Subsection B above for each year,
				through the year that the applicant or eligible recipient received both social
				security benefits and supplemental security income (SSI); the final result is
				the countable social security benefit.
COLA Increase and disregard table
Period and year
COLA increase
= benefit before
1
2024 Jan - Dec
3.2
Jan 24
2
2023 Jan - Dec
8.7
Jan 23
3
2022 Jan - Dec
5.9
Jan 22
4
2021 Jan - Dec
1.3
Jan 21
5
2020 Jan - Dec
1.6
Jan 20
6
2019 Jan - Dec
2.8
Jan 19
7
2018 Jan - Dec
2.0
Jan 18
8
2017 Jan - Dec
0.3
Jan 17
9
2016 Jan - Dec
0
Jan 16
10
2015 Jan - Dec
1.017
Jan 15
11
2014 Jan - Dec
1.015
Jan 14
12
2013 Jan - Dec
1.017
Jan 13
13
2012 Jan - Dec
1.037
Jan 12
14
2011 Jan - Dec
0
Jan 11
15
2010 Jan - Dec
1
Jan 10
16
2009 Jan - Dec
1
Jan 09
17
2008 Jan - Dec
1.058
Jan 08
18
2007 Jan - Dec
1.023
Jan 07
19
2006 Jan - Dec
1.033
Jan 06
20
2005 Jan - Dec
1.041
Jan 05
21
2004 Jan - Dec
1.027
Jan 04
22
2003 Jan - Dec
1.021
Jan 03
23
2002 Jan - Dec
1.014
Jan 02
24
2001 Jan - Dec
1.026
Jan 01
25
2000 Jan - Dec
1.035
Jan 00
26
1999 Jan - Dec
1.025
Jan 99
27
1998 Jan - Dec
1.013
Jan 98
28
1997 Jan - Dec
1.021
Jan 97
29
1996 Jan - Dec
1.029
Jan 96
30
1995 Jan - Dec
1.026
Jan 95
31
1994 Jan - Dec
1.028
Jan 94
32
1993 Jan - Dec
1.026
Jan 93
33
1992 Jan - Dec
1.03
Jan 92
34
1991 Jan - Dec
1.037
Jan 91
35
1990 Jan - Dec
1.054
Jan 90
36
1989 Jan - Dec
1.047
Jan 89
37
1988 Jan - Dec
1.04
Jan 88
38
1987 Jan - Dec
1.042
Jan 87
39
1986 Jan - Dec
1.013
Jan 86
40
1985 Jan - Dec
1.031
Jan 85
41
1984 Jan - Dec
1.035
Jan 84
42
1982 Jul - 1983 Dec
1.035
Jul 82
43
1981 Jul - 1982 Jun
1.074
Jul 81
44
1980 Jul - 1981 Jun
1.112
Jul 80
45
1979 Jul - 1980 Jun
1.143
Jul 79
46
1978 Jul - 1979 Jun
1.099
Jul 78
47
1977 Jul - 1978 Jun
1.065
Jul 77
48
1977 Apr - 1977 Jun
1.059
Apr 77
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.13 - FEDERAL BENEFIT RATES (FBR) AND VALUE OF ONE-THIRD REDUCTION (VTR)

Current through Register Vol. 35, No. 13, July 16, 2024
Year
Individual
Institution
Individual
Couple
Institution
Couple
FBR
FBR
VTR
FBR
FBR
VTR
1/89 to 1/90
$368
$30
$122.66
$553
$60
$184.33
1/90 to 1/91
$386
$30
$128.66
$579
$60
$193.00
1/91 to 1/92
$407
$30
$135.66
$610
$60
$203.33
1/92 to 1/93
$422
$30
$140.66
$633
$60
$211.00
1/93 to 1/94
$434
$30
$144.66
$652
$60
$217.33
1/94 to 1/95
$446
$30
$148.66
$669
$60
$223.00
1/95 to 1/96
$458
$30
$152.66
$687
$60
$229.00
1/96 to 1/97
$470
$30
$156.66
$705
$60
$235.00
1/97 to 1/98
$484
$30
$161.33
$726
$60
$242.00
1/98 to 1/99
$494
$30
$164.66
$741
$60
$247.00
1/99 to 1/00
$500
$30
$166.66
$751
$60
$250.33
1/00 to 1/01
$512
$30
$170.66
$769
$60
$256.33
1/01 to 1/02
$530
$30
$176.66
$796
$60
$265.33
1/02 to 1/03
$545
$30
$181.66
$817
$60
$272.33
1/03 to 1/04
$552
$30
$184.00
$829
$60
$276.33
1/04 to 1/05
$564
$30
$188
$846
$60
$282.00
1/05 to 1/06
$579
$30
$193
$869
$60
$289.66
1/06 to 1/07
$603
$30
$201
$904
$60
$301.33
1/07 to 1/08
$623
$30
$207.66
$934
$60
$311.33
1/08 to 1/09
$637
$30
$212.33
$956
$60
$318.66
1/09 to 1/10
$674
$30
$224.66
$1,011
$60
$337
1/10 to 1/11
$674
$30
$224.66
$1,011
$60
$337
1/11 to 1/12
$674
$30
$224.66
$1,011
$60
$337
1/12 to 1/13
$698
$30
$232.66
$1,048
$60
$349.33
1/13 to 1/14
$710
$30
$237
$1,066
$60
$355
1/14 to 1/15
$721
$30
$240
$1,082
$60
$361
1/15 to 12/15
$733
$30
$244
$1,100
$60
$367
1/16 to 12/16
$733
$30
$244
$1,100
$60
$367
1/17 to 12/17
$735
$30
$245
$1,103
$60
$368
1/18 to 12/18
$750
$30
$250
$1,125
$60
$375
1/19 to 12/19
$771
$30
$257
$1,157
$60
$386
1/20 to 12/20
$783
$30
$261
$1,175
$60
$392
1/21 to 12/21
$794
$30
$264.66
$1,191
$60
$397
1/22 to 12/22
$841
$30
$280.33
$1,261
$60
$420.50
1/23 to 12/23
$914
$30
$304.66
$1,371
$60
$456.99
1/24 to 12/24
$943
$30
$314.33
$1,415
$60
$471.66
A. Ineligible
				child deeming allocation is $472.
B. Part B premium is $174.70 per
				month.
C. VTR (value of one third
				reduction) is used when an individual or a couple lives in the household of
				another and receives food and shelter from the household or when the individual
				or the couple is living on his or her own household but receiving support and
				maintenance from others.
D. The SSI
				resource standard is $2000 for an individual and $3000 for a couple.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.14 - UNISEX LIFE ESTATE AND REMAINDER INTEREST TABLES

Current through Register Vol. 35, No. 13, July 16, 2024
Age
Life Estate
Remainder
0
.97188
.02812
1
.98988
.01012
2
.99017
.00983
3
.99008
.00992
4
.98981
.01019
5
.98938
.01062
6
.98884
.01116
7
.98822
.01178
8
.98748
.01252
9
.98663
.01337
10
.98565
.01435
11
.98453
.01547
12
.98329
.01671
13
.98198
.01802
14
.98066
.01934
15
.97937
.02063
16
.97815
.02185
17
.97700
.02300
18
.97590
.02410
19
.97480
.02520
20
.97365
.02635
21
.97245
.02755
22
.97120
.02880
23
.96986
.03014
24
.96841
.03159
25
.96678
.03322
26
.96495
.03505
27
.96290
.03710
28
.96062
.03938
29
.95813
.04187
30
.95543
.04457
31
.95243
.04746
32
.94942
.05058
33
.94608
.05392
34
.94250
.05750
35
.93868
.06132
36
.93460
.06540
37
.93026
.06974
38
.92567
.07433
39
.92083
.07917
40
.91571
.08429
41
.91030
.08970
42
.90457
.09543
43
.89855
.10145
44
.89221
.10779
45
.88558
.11442
46
.87863
.12137
47
.87137
.12863
48
.86374
.13626
49
.85578
.14422
50
.84743
.15257
51
.83674
.16126
52
.82969
.17031
53
.82028
.17972
54
.81054
.18946
55
.80046
.19954
56
.79006
.20994
57
.77931
.22069
58
.76822
.23178
59
.75675
.24325
60
.74491
.25509
61
.73267
.26733
62
.72002
.27998
63
.70696
.29304
64
.69352
.30648
65
.67970
.32030
66
.66551
.33449
67
.65098
.34902
68
.63610
.36690
69
.62086
.37914
70
.60522
.39478
71
.58914
.41086
72
.57261
.42739
73
.55571
.44429
74
.53862
.46138
75
.52149
.47851
76
.50441
.49559
77
.48742
.51258
78
.47049
.52951
79
.45357
.54643
80
.43659
.56341
81
.41967
.58033
82
.42095
.59705
83
.38642
.61358
84
.36998
.63002
85
.35359
.64641
86
.33764
.66236
87
.32262
.67738
88
.30859
.69141
89
.29526
.70474
90
.28221
.71779
91
.26955
.73045
92
.25771
.74229
93
.24692
.75308
94
.23728
.76272
95
.22887
.77113
96
.22181
.77819
97
.21550
.78450
98
.21000
.79000
99
.20486
.79514
100
.19975
.80025
101
.19532
.80468
102
.19054
.80946
103
.18437
.81563
104
.17856
.82144
105
.16962
.83038
106
.15488
.84512
107
.13409
.86591
108
.10068
.89932
109
.04545
.95455
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.15 - SUPPLEMENTAL SECURITY INCOME (SSI) LIVING ARRANGEMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A. Individual living in his or her own
				household who own or rent:
Payment amount:
$943
Individual
$1,415
Couple
B.
				Individual receiving support and maintenance payments: For an individual or
				couple living in his or her own household, but receiving support and
				maintenance from others (such as food, shelter or clothing), subtract the value
				of one third reduction (VTR).
Payment amount:
$943 - $314.33 = $628.67
Individual
$1,415 - $471.66 = $943.34
Couple
C.
				Individual or couple living household of another: For an individual or couple
				living in another person's household and not contributing his or her pro-rata
				share of household expenses, subtract the VTR.
Payment amount:
$943 - $314.33 = $628.67
Individual
$1,415 - $471.66 = $943.34
Couple
D.
				Child living in home with his or her parent:
Payment amount: $943
E. Individual in institution:
Payment amount: $30.00
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.16 - MAXIMUM COUNTABLE INCOME FOR INSTITUTIONAL CARE MEDICAID AND HOME AND COMMUNITY BASED WAIVER SERVICES (HCBS) CATEGORIES

Current through Register Vol. 35, No. 13, July 16, 2024
Effective January 1, 2024, the maximum countable monthly
				  income standard for institutional care medicaid and the home and community
				  based waiver categories is $2,829.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.17 - MAXIMUM COUNTABLE INCOME FOR CHILDREN YOUTH AND FAMILIES (CYFD)

Current through Register Vol. 35, No. 13, July 16, 2024
Effective July 1, 1995, the maximum countable monthly income
				  standard for CYFD medicaid is $231.00.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.18 - SSI RELATED CATEGORIES - DEEMING INCOME WHEN AN APPLICANT CHILD IS LIVING WITH INELIGIBLE PARENT

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Monthly computation:
(1) total gross unearned
				income of parent;
(2) deduct living
				allowance for ineligible child and SSI-eligible sponsored alien (one half of
				the monthly SSI FBR LA code A*) for each ineligible child/SSI-eligible
				sponsored alien);
(3)
				subtotal;
(4) deduct $20.00 general
				income exclusion - 20.00;
(5)
				unearned income subtotal;
(6) total
				gross earned income of parent;
(7)
				deduct any remaining allocation for ineligible child and/or SSI-eligible
				sponsored alien; see Paragraph (2) above;
(8) subtotal;
(9) deduct any remaining portion of the
				$20.00 general income exclusion only if not already totally deducted in
				Paragraph (4) above;
(10)
				subtotal;
(11) deduct $65.00; do
				not apply this deduction if the only income is unearned - 65.00;
(12) subtotal;
(13) subtract one-half of Paragraph (12); do
				not apply this deduction if the only income is unearned;
(14) earned income subtotal;
(15) total of Paragraph (5) plus Paragraph
				(14);
(16) deduct parental
				allocation (1 parent = SSI FBR for an individual LA code A*) (2 parents = SSI
				FBR for an eligible couple LA code A*);
(17) income deemed to applicant child; if
				there is more than one applicant child, divide this amount equally between the
				children:
*
LA Code A = the full SSI FBR for an individual or a
				couple.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.19 - LIFE EXPECTANCY TABLES A

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Males:
Age
Life expectancy
Age
Life expectancy
Age
Life expectancy
0
71.80
40
35.05
80
6.98
1
71.53
41
34.15
81
6.59
2
70.58
42
33.26
82
6.21
3
69.62
43
32.37
83
5.85
4
68.65
44
31.49
84
5.51
5
67.67
45
30.61
85
5.19
6
66.69
46
29.74
86
4.89
7
65.71
47
28.88
87
4.61
8
64.73
48
28.02
88
4.34
9
63.74
49
27.17
89
4.09
10
62.75
50
26.32
90
3.86
11
61.76
51
25.48
91
3.64
12
60.78
52
24.65
92
3.43
13
59.79
53
23.82
93
3.24
14
58.82
54
23.01
94
3.06
15
57.85
55
22.21
95
2.90
16
56.91
56
21.43
96
2.74
17
55.97
57
20.66
97
2.60
18
55.05
58
19.90
98
2.47
19
54.13
59
19.15
99
2.34
20
53.21
60
18.42
100
2.22
21
52.29
61
17.70
101
2.11
22
51.38
62
16.99
102
1.99
23
50.46
63
16.30
103
1.89
24
49.55
64
15.62
104
1.78
25
48.63
65
14.96
105
1.68
26
47.72
66
14.32
106
1.59
27
46.80
67
13.70
107
1.50
28
45.88
68
13.09
108
1.41
29
44.97
69
12.50
109
1.33
30
44.06
70
11.92
110
1.25
31
43.15
71
11.35
111
1.17
32
42.24
72
10.80
112
1.10
33
41.33
73
10.27
113
1.02
34
40.23
74
9.27
114
0.96
35
39.52
75
9.24
115
0.89
36
38.62
76
8.76
116
0.83
37
37.73
77
8.29
117
0.77
38
36.83
78
7.83
118
0.71
39
35.94
79
7.40
119
0.66
B.
Females:
Age
Life expectancy
Age
Life expectancy
Age
Life expectancy
0
78.79
40
40.61
80
9.11
1
78.42
41
39.66
81
8.58
2
77.48
42
38.72
82
8.06
3
76.51
43
37.78
83
7.56
4
75.54
44
36.85
84
7.08
5
74.56
45
35.92
85
6.63
6
73.57
46
35.00
86
6.20
7
72.59
47
34.08
87
5.79
8
71.60
48
33.17
88
5.41
9
70.61
49
32.27
89
5.05
10
69.62
50
31.37
90
4.71
11
68.63
51
30.48
91
4.40
12
67.64
52
29.60
92
4.11
13
66.65
53
28.72
93
3.84
14
65.67
54
27.86
94
3.59
15
64.68
55
27.00
95
3.36
16
63.71
56
26.15
96
3.16
17
62.74
57
25.31
97
2.97
18
61.77
58
24.48
98
2.80
19
60.80
59
23.67
99
2.64
20
59.83
60
22.86
100
2.48
21
58.86
61
22.06
101
2.34
22
57.89
62
21.27
102
2.20
23
56.92
63
20.49
103
2.06
24
55.95
64
19.72
104
1.93
25
54.98
65
18.96
105
1.81
26
54.02
66
18.21
106
1.69
27
53.05
67
17.48
107
1.58
28
52.08
68
16.76
108
1.48
29
51.12
69
16.04
109
1.38
30
50.15
70
15.35
110
1.28
31
49.19
71
14.66
111
1.19
32
48.23
72
13.99
112
1.10
33
47.27
73
13.33
113
1.02
34
46.31
74
12.68
114
0.96
35
45.35
75
12.05
115
0.89
36
44.40
76
11.43
116
0.83
37
43.45
77
10.83
117
0.77
38
42.50
78
10.24
118
0.71
39
41.55
79
9.67
119
0.66
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.20 - COVERED QUARTER INCOME STANDARD

Current through Register Vol. 35, No. 13, July 16, 2024
Date
Calendar Quarter Amount
Jan. 2024 - Dec. 2024
$1,730 per calendar quarter
Jan. 2023 - Dec. 2023
$1,640 per calendar quarter
Jan. 2022 - Dec. 2022
$1,510 per calendar quarter
Jan. 2021 - Dec. 2021
$1,470 per calendar quarter
Jan. 2020 - Dec. 2020
$1,410 per calendar quarter
Jan. 2019 - Dec. 2019
$1,360 per calendar quarter
Jan. 2018 - Dec. 2018
$1,320 per calendar quarter
Jan. 2017 - Dec. 2017
$1,300 per calendar quarter
Jan. 2016 - Dec. 2016
$1,260 per calendar quarter
Jan. 2015 - Dec. 2015
$1,220 per calendar quarter
Jan. 2014 - Dec. 2014
$1,200 per calendar quarter
Jan. 2013 - Dec. 2013
$1,160 per calendar quarter
Jan. 2012 - Dec. 2012
$1,130 per calendar quarter
Jan. 2011 - Dec. 2011
$1,120 per calendar quarter
Jan. 2010 - Dec. 2010
$1,120 per calendar quarter
Jan. 2009 - Dec. 2009
$1,090 per calendar quarter
Jan. 2008 - Dec. 2008
$1,050 per calendar quarter
Jan. 2007 - Dec. 2007
$1,000 per calendar quarter
Jan. 2006 - Dec. 2006
$970 per calendar quarter
Jan. 2005 - Dec. 2005
$920 per calendar quarter
Jan. 2004 - Dec. 2004
$900 per calendar quarter
Jan. 2003 - Dec. 2003
$890 per calendar quarter
Jan. 2002 - Dec. 2002
$870 per calendar quarter
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT RULES › Part 520 - INCOME STANDARDS › Section 8.200.520.21 - STANDARD OF NEED (SON)

Current through Register Vol. 35, No. 13, July 16, 2024
Budget group size
Gross income test
Net income test
185% Standard of need
Standard of need
049/059 Refugee
049/059 Refugee
1
$791
$266
2
$1,072
$357
3
$1,352
$447
4
$1,633
$539
5
$1,913
$630
6
$2,194
$721
7
$2,474
$812
8
$2,755
$922
+1
+ $281
+ $91
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 201 - MEDICAID ELIGIBILITY - MEDICAID EXTENSION (CATEGORY 01, 03 and 04) › Part 400 - RECIPIENT POLICIES › Section 8.201.400.3 - RESERVED

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 Sections 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.
The
				  amended version of this part by
				  New
				  Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff.
				  7/1/2024 is not yet
				  available.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 201 - MEDICAID ELIGIBILITY - MEDICAID EXTENSION (CATEGORY 01, 03 and 04) › Part 400 - RECIPIENT POLICIES › Section 8.201.400.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
January 1, 2019, unless a later date is cited at the end of
				  the section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 201 - MEDICAID ELIGIBILITY - MEDICAID EXTENSION (CATEGORY 01, 03 and 04) › Part 400 - RECIPIENT POLICIES › Section 8.201.400.6 - 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 201 - MEDICAID ELIGIBILITY - MEDICAID EXTENSION (CATEGORY 01, 03 and 04) › Part 400 - RECIPIENT POLICIES › Section 8.201.400.9 - MEDICAID EXTENSION - CATEGORIES 001, 003 AND 004

Current through Register Vol. 35, No. 13, July 16, 2024
Medicaid extension (categories 001, 003 and 004) provides
				  coverage for certain groups of individuals who have lost eligibility for
				  supplemental security income (SSI) for specified reasons.