New Mexico Administrative Code › Title 9 - HUMAN RIGHTS › Chapter 2 - AGE › Part 12 - CORPORATE ELDERCARE › Section 9.2.12.11 - MINIMUM CONTRACT REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
A. An area agency cannot execute an agreement
				or contract that demands exclusivity. An area agency must be free to negotiate
				other similar agreements or contracts.
B. An area agency cannot enter into an
				agreement or contract that obligates it to be identified with or to promote the
				company or its products, or places it in a conflict of interest with its public
				mission.
C. The contract must state
				that the area agency has the right to refuse services to a company or its
				employees or clients in the event that there is a potential conflict of
				interest for the area agency, as identified by the area agency or state
				agency.
D. The contract must
				provide that an area agency has the right to reveal its findings, plans and
				recommendations to the client, regardless of the company's final decision
				regarding client eligibility and/or services provided.
E. The contract must provide that all
				information, as to personal facts and circumstances, obtained by the area
				agency shall be treated as privileged communications, shall be held
				confidential, and shall not be divulged without the written consent of the
				individual receiving the services, his/her attorney, or his/her legal guardian,
				except as is required by the corporation, insurance company, or brokering
				agent, or as may be required by the state agency for the purposes of monitoring
				for compliance with the provisions of this policy, directed by the state or
				federal court. However, nothing prohibits the disclosure of information in
				summary, statistical or other form which does not identify particular
				individuals.
F. The contract must
				provide that the information obtained through the performance of the contract
				be treated as confidential information. The area agency shall not use any
				information obtained in the performance of the contract in any manner except as
				necessary to the proper discharge of its obligations. All area agency personnel
				having access to information pertaining to individuals receiving services shall
				complete and sign a nondisclosure agreement.
G. The contract must hold the area agency and
				the state agency, where it is a party to the contract, harmless and defend them
				in any actions brought against them on the basis of companies' policies or
				decisions regarding benefits and services.
H. Provisions of the contract may not require
				the withholding of information or otherwise limit the ability of the area
				agency to judge or act in the public interest; nor may they restrict the
				ability of state agency to exercise appropriate oversight of the area agency in
				its fulfillment of its public mission and responsibilities.
I. In contracts covering long-term care
				insurance case management services, companies must assure:
(1) they are financially stable, are in good
				standing and are in compliance with all statutes and rules governing insurance
				companies in the state of New Mexico; and
(2) their long-term care insurance policies
				comply with the New Mexico insurance laws.