reglab/statecodes huggingface dataset:
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 400 - RECIPIENT POLICIES › Section 8.231.400.16 - AGE

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant/recipient newborn is eligible for medicaid under
				  this category from birth through the month of the child's first
				  birthday.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 400 - RECIPIENT POLICIES › Section 8.231.400.17 - RECIPIENT RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant/recipient is responsible for establishing
				  his/her eligibility for medicaid. As part of this responsibility, the
				  applicant/recipient 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. An applicant/recipient 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 400 - RECIPIENT POLICIES › Section 8.231.400.18 - ASSIGNMENT OF SUPPORT

Current through Register Vol. 35, No. 13, July 16, 2024
Assignment of child support rights is not required for
				  applicants/recipients eligible for category 031.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.1 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.2 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.3 - 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 and by the state human
				  services department 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.5 - EFFECTIVE DATE

Current through Register Vol. 35, No. 13, July 16, 2024
October 1, 2017, unless a later date is cited at the end of a
				  section.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.6 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.10 - RESOURCE STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
Resources are not a factor in the eligibility determination
				  for category 031.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.231.500.11 - INCOME STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
Income is not a factor in the eligbility determination for
				  category 031.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.1 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.2 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.3 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.5 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.6 - 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. Processes for establishing and maintaining this category
				  of eligibility are found in the affordable care general provision chapters
				  located at 8.291.400 NMAC through 8.291.430 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.8 - 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 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.9 - BENEFIT DESCRIPTION

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant or recipient who is eligible for medicaid under
				  this category is eligible to receive the full range of medicaid
				  services.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.10 - BENEFIT DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Medical service providers must give the name and case number of the New Mexico
				medicaid eligible mother and the name, birth date, sex of the newborn, and the
				name of the hospital where the birth occurred to local county income support
				division (ISD) office. Within three days after receipt of this information, the
				income support specialist (ISS):
(1)
				determines if the mother was eligible for New Mexico medicaid at the time of
				birth or if the birth and delivery was covered by emergency medical services to
				undocumented non-citizens (EMSNC);
(2) registers the newborn for medicaid on the
				system; a signed application is not required;
(3) provides eligibility information to the
				hospital; and
(4) notifies the
				mother that a signed application is necessary to establish the newborn's
				eligibility for temporary assistance for needy families (TANF), if
				applicable.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.11 - ONGOING BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
A newborn remains eligible for assistance under Category 031
				  from birth through the month of the child's first birthday as long as the
				  newborn remains in New Mexico.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.12 - RETROACTIVE BENEFIT COVERAGE

Current through Register Vol. 35, No. 13, July 16, 2024
Retroactive medicaid coverage is provided in accordance with
				  Subsection H of
				  8.200.400.14
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.13 - CHANGE IN ELIGIBILITY

Current through Register Vol. 35, No. 13, July 16, 2024
If the newborn is placed on MAD Category 400 or 420 and then
				  loses eligibility for either of these categories, the newborn can still be
				  eligible for Category 031 if he meets Category 031 requirements for the
				  remainder of the 12 month period. A new application is not
				  required
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.14 - PERIODIC REDETERMINATIONS OF ELIGIBILITY (42 CFR 435.117(d))

Current through Register Vol. 35, No. 13, July 16, 2024
A redetermination of eligibility must be completed on behalf
				  of the children described in this provision in accordance with
				  8.291.410.19
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 231 - MEDICAID ELIGIBILITY - INFANTS OF MOTHERS WHO ARE MEDICAID OR MEDICAL ASSISTANCE PROGRAM ELIGIBLE › Part 600 - BENEFIT DESCRIPTION › Section 8.231.600.15 - ENUMERATION AND CITIZENSHIP

Current through Register Vol. 35, No. 13, July 16, 2024
A. HSD
				requires, as a condition of eligibility, that each individual (including
				children) seeking medicaid furnish each of his or her social security numbers
				(SSN) per paragraph (a) of 42 CFR 435.910 and
				8.200.410.10
				NMAC. HSD will request an SSN at renewal if not already provided.
B. Newborns who were initially eligible for
				medicaid as deemed newborns are considered to have provided satisfactory
				documentation of citizenship, identity, and age.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.1 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.2 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.3 - 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, NMSA 1978, Section 27-1-12 et seq.
				  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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.5 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.6 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.8 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.9 - MEDICAID ELIGIBILITY FOR INDIVIDUALS INELIGIBILE FOR SSI DUE TO DEEMED INCOME OR RESOURCES FROM A NON-CITIZEN SPONSOR - CATEGORY 034

Current through Register Vol. 35, No. 13, July 16, 2024
A. An individual
				must meet specific eligibility requirements. These include:
(1) an individual meets the social security
				administration (SSA) definitions of aged, blind, or disabled and is ineligible
				for supplemental security income (SSI) solely because of deemed income or
				resource considered available from a non-citizen sponsor;
(2) an individual who meets the eligibility
				requirements pursuant to 8.200.410 NMAC and 8.200.420 NMAC for citizenship or
				non-citizen status, enumeration, residence; non-concurrent receipt of
				assistance, and applications for other benefits;
(3) an applicant or recipient must assign
				medical support rights to HSD and agree to cooperate with third party liability
				responsibilities pursuant to 8.200.430 NMAC; and
(4) appropriate to the budget group size,
				countable income must be less than the SSI federal benefit rate (FBR) income
				pursuant to 8.200.520 NMAC, 8.215 NMAC and 8.234.500 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.11 - ENUMERATION

Current through Register Vol. 35, No. 13, July 16, 2024
Refer to
				  8.200.410.10
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.12 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.13 - RESIDENCE

Current through Register Vol. 35, No. 13, July 16, 2024
Refer to
				  8.200.410.12
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.15 - SSI STATUS

Current through Register Vol. 35, No. 13, July 16, 2024
A. An applicant
				or re-determining recipient for Category 034 must meet all other SSI
				eligibility standards, including:
(1)
				applicant or re-determining recipient's own income and resources must be below
				SSI standards;
(2) nonconcurrent
				receipt of assistance;
(3)
				residence;
(4) aged, blind, or
				disabled status; and
(5)
				citizenship or permanent non-citizen status.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.16 - RECIPIENT RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
Refer to 8.200.430 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.17 - BASIS FOR DEFINING THE ASSISTANCE UNIT AND BUDGET GROUP

Current through Register Vol. 35, No. 13, July 16, 2024
At the time of application, an applicant shall identify
				  everyone who is to be considered for inclusion in the assistance unit and
				  budget group. The composition of the assistance unit and budget group is based
				  on the relationship of the household members. Each member of the assistance
				  unit and budget group, including an unborn child, is counted as one in the
				  household size.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.18 - ASSISTANCE UNIT

Current through Register Vol. 35, No. 13, July 16, 2024
The assistance unit includes the applicant and may include
				  others in the household who are determined eligible.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.19 - BUDGET GROUP

Current through Register Vol. 35, No. 13, July 16, 2024
The budget group includes all members of the assistance
				  unit. Additional budget group members include individuals who live in the
				  household with the assistance unit and have a financial obligation of
				  support.
A. Except for an SSI
				recipient, the following individuals have a financial obligation of support for
				medicaid eligibility:
(1) spouses: married
				individuals as defined under applicable New Mexico state law (New Mexico
				recognizes common law and same sex marriages established in other states);
				and
(2) parents for children: there
				is a presumption that a child born to a married woman is the child of the
				spouse, or if the individual established parentage by some other legally
				recognized process.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 400 - RECIPIENT REQUIREMENTS › Section 8.234.400.20 - LIVING IN THE HOME

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Living in the home with a relative:
To be included in the
				assistance unit, a child must be living, or considered to be living, in the
				home of:
(1) a natural or an adoptive parent;
				there is a presumption that a child born to a married woman is the child of the
				spouse, or if the individual established parentage by some other legally
				recognized process; or
(2) a
				specified relative who is related within the fifth degree of relationship by
				blood, marriage or adoption and assumes responsibility for the day-to-day care
				and control of the child; the determination of whether an individual functions
				as the specified relative shall be made by the specified relative unless other
				information known to the worker clearly indicates otherwise.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.1 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.2 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.3 - 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 NMSA 1978, Section 27-1-12 et seq.
				  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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.4 - DURATION

Current through Register Vol. 35, No. 13, July 16, 2024
Permanent.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.5 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.6 - 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 MAD eligibility are detailed in the income support
				  division (ISD) general provisions policy manual, 8.100 NMAC,
General
				  Provisions for Public Assistance Programs
.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.7 - DEFINITIONS

Current through Register Vol. 35, No. 13, July 16, 2024
[RESERVED]
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.8 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.9 - NEED DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
An individual's financial need is based on meeting
				  supplemental security income (SSI) federal benefit rate (FBR) income and
				  resource methodology pursuant to 8.215.500 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.10 - RESOURCE STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The resource standards for establishing eligibility are
				  described in 8.215.500 NMAC. The resources of a non-citizen sponsor are not
				  considered when determining eligibility.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.234.500.11 - INCOME STANDARDS

Current through Register Vol. 35, No. 13, July 16, 2024
The income standards for establishing eligibility are
				  described in 8.215.500 NMAC. The income of a non-citizen sponsor is not
				  considered when determining eligibility.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.1 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.2 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.3 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.5 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.6 - 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 Chapter 8.100 NMAC,
General
				  Provisions for Public Assistance Programs
.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.8 - 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 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.9 - BENEFIT DESCRIPTION

Current through Register Vol. 35, No. 13, July 16, 2024
Under the eligibility Category 034, an eligible recipient
				  receives the full range of medicaid covered services.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.10 - BENEFIT DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
A.
				Income support division (ISD) determines initial and ongoing
				eligibility.
B. Up to three months
				of retroactive medicaid coverage is provided to an applicant who has received a
				medicaid covered service during the retroactive period and who would have met
				applicable eligibility criteria had they applied earlier. Eligibility for each
				retroactive month is determined separately. An application for retroactive
				medicaid enrollment must be made within 180 calendar days from the date of the
				medicaid application.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.11 - INITIAL BENEFITS

Current through Register Vol. 35, No. 13, July 16, 2024
A.
Move during eligibility determination:
If an applicant moves to
				another county while the eligibility determination is pending, the county ISD
				office in which the application was originally registered shall transfer the
				case to the new responsible office.
B.
Delays in eligibility
				determination:
If an eligibility determination is not made within the
				time limit, the applicant is notified in writing of the reason for the delay.
				This notice also informs the applicant or re-determining recipient of the right
				to request an administrative hearing.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.12 - PERIODIC REDETERMINATIONS OF ELIGIBILITY

Current through Register Vol. 35, No. 13, July 16, 2024
A. A re-determination of eligibility is made
				every 12 months.
B. All changes
				that may affect eligibility must be reported within 10 calendar days from the
				date of the change as detailed in 8.200.430 NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 234 - MEDICAID ELIGIBILITY - SSI INELIGIBILITY - DUE TO INCOME OR RESOURCES FROM AND ALIEN SPONSOR › Part 600 - BENEFIT DESCRIPTION › Section 8.234.600.13 - SSI RETROACTIVE BENEFIT COVERAGE

Current through Register Vol. 35, No. 13, July 16, 2024
Up to three months of retroactive medicaid coverage can be
				  furnished to applicants who have received medicaid covered services during the
				  retroactive period and would have met applicable eligibility criteria had they
				  applied during the three months prior to the month of application [
				  42 CFR 435.914
				  ].
A.
Application for
				retroactive benefit coverage:
Application for retroactive medicaid can
				be made by checking "yes" in the "application for retroactive medicaid
				payments" box on the application or re-determination of eligibility for medical
				assistance (MAD 381) form or by checking "yes" to the question "does anyone in
				your household have unpaid medical expenses in the last three months?" on the
				application for assistance (ISD 100 S) form. Applications for retroactive
				supplemental security income (SSI) medicaid benefits for recipients of SSI must
				be made by 180 days from the date of approval for SSI. Medicaid covered
				services which were furnished more than two years prior to approval are not
				covered.
B.
Approval
				requirements:
To establish retroactive eligibility, the income support
				specialist (ISS) must verify that all conditions of eligibility were met for
				each of the three retroactive months and that the applicant received medicaid
				covered services. Eligibility for each month is approved or denied on its own
				merits.
(1) Applicable benefit rate: The
				federal benefit rate (FBR) in effect during the retroactive months based on the
				applicant's living arrangements is applicable for retroactive medicaid
				eligibility determinations. See 8.200.520.10 NMAC. If the applicant's countable
				income in a given month exceed the applicable FBR, the applicant is not
				eligible for retroactive medicaid for that month. If the countable income is
				less that the FBR, the applicant is eligible on the factor of income for that
				month. A separate determination must be made for each of the three months in
				the retroactive period.
(2)
				Disability determination required: If a determination is needed of the date of
				onset of blindness or disability, the ISS must send a referral to disability
				determination services (ISD 305) to the disability determination
				unit.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.1 - 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 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.3 - 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, and 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 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.5 - 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 400 - RECIPIENT POLICIES › Section 8.240.400.6 - 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 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.9 - QUALIFIED MEDICARE BENEFICIARIES (QMB) - CATEGORY 040

Current through Register Vol. 35, No. 13, July 16, 2024
To be eligible for the qualified medicare beneficiaries
				  program (QMB), an applicant/recipient must be covered by medicare part A.
				  Medicare part A is a free entitlement to social security beneficiaries who are
				  65 years of age or older or who have received social security disability
				  payments for 24 months. Fully or currently insured workers, or their
				  dependents, who have end-stage renal disease are also covered under
				  medicare.
Most applicants/recipients 65 years of age or older who do
				  not receive free medicare part A can voluntarily enroll for hospital insurance
				  coverage, with payment of a monthly premium. Voluntary enrollees must also
				  enroll for supplementary medical insurance, medicare part B, and pay that
				  premium, as well.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.10 - BASIS FOR DEFINING THE GROUP

Current through Register Vol. 35, No. 13, July 16, 2024
Applicants/recipients eligible for medicaid coverage under
				  any other category may be eligible for coverage under QMB. QMB eligibility
				  affords two advantages when an applicant/ recipient is already eligible for
				  medicaid:
A. medicare premium part A
				is payable by medicaid; and
B.
				medicaid receives federal matching funds for purchase of medicare part
				B.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.12 - ENUMERATION

Current through Register Vol. 35, No. 13, July 16, 2024
Applicants/recipients must furnish their social security
				  account number(s). QMB eligibility is denied or terminated if
				  applicants/recipients fail to furnish their social security
				  numbers.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.13 - CITIZENSHIP

Current through Register Vol. 35, No. 13, July 16, 2024
A. Refer to medical
				assistance program manual
				8.200.410.11 NMAC.
B. Verification of citizenship: Citizenship
				determinations rendered by the social security administration (SSA) for SSI are
				final.
(1) Documentation of citizenship:
				Primary documentation of citizenship is a birth certificate. Secondary
				documentation includes:
(a) certificate of
				naturalization;
(b) citizenship
				certificate;
(c) other resident
				identification documents issued by the United States immigration and
				naturalization service, such as:
(i) U.S.
				passport issued by the U.S. state department;
(ii) consular report of birth;
(iii) certification of birth issued by the
				U.S. state department, proof of marriage to a U.S. citizen before September 2,
				1922, or a card of identity and registration of a U.S. citizen; or
(iv) official communication from an American
				foreign service post indicating that an applicant/recipient is registered as a
				United States citizen.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.14 - RESIDENCE

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant/recipient must be physically present in New
				  Mexico on the date of application or final determination of eligibility and
				  have demonstrated intent to remain in the state. If the applicant/recipient
				  does not have the present mental capacity to declare intent, the parent,
				  guardian or adult child can assume responsibility for a declaration of intent.
				  If there is no guardian or relative to assume responsibility for a declaration
				  of intent, the state where the applicant/ recipient is living is recognized as
				  the state of residence. A temporary absence from the state does not prevent
				  eligibility. A temporary absence exists if an applicant/ recipient leaves the
				  state for a specific purpose with a time-limited goal and intends to return to
				  New Mexico when the purpose is accomplished.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.15 - NONCONCURRENT RECEIPT OF ASSISTANCE

Current through Register Vol. 35, No. 13, July 16, 2024
A QMB applicant/recipient on buy-in in another state cannot
				  be approved for QMB in New Mexico until the other state's buy-in is
				  terminated.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.16 - SPECIAL RECIPIENT REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
There is no special recipient requirements such as age or
				  disability for QMB.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.17 - RECIPIENT RIGHTS AND RESPONSIBILITIES

Current through Register Vol. 35, No. 13, July 16, 2024
An applicant/recipient is responsible for establishing their
				  eligibility for medicaid. As part of this responsibility, the
				  applicant/recipient 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. An applicant/recipient must also
				  grant the HCA 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 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.18 - ASSIGNMENTS OF MEDICAL SUPPORT

Current through Register Vol. 35, No. 13, July 16, 2024
Refer to medical assistance program manual Subsection F of
				  8.200.420.12
				  NMAC.
New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 400 - RECIPIENT POLICIES › Section 8.240.400.19 - REPORTING REQUIREMENTS

Current through Register Vol. 35, No. 13, July 16, 2024
All medicaid recipients must report any change in their
				  circumstances which can affect eligibility to the local income support division
				  (ISD) office within 10 days of the change.
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 8.240.500.1 - 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 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.2 - 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 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.3 - 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, and 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 240 - MEDICAID ELIGIBILITY - QUALIFIED MEDICARE BENEFICIARIES (QMB) (CATEGORY 040) › Part 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.5 - 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 the
				  section.
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 8.240.500.6 - OBJECTIVE

Current through Register Vol. 35, No. 13, July 16, 2024
The objective of this rule 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 500 - INCOME AND RESOURCE STANDARDS › Section 8.240.500.9 - GENERAL NEED DETERMINATION

Current through Register Vol. 35, No. 13, July 16, 2024
Applicants for, or recipients of, the qualified medicare
				  beneficiaries (QMB) program must apply for and take all necessary steps to
				  obtain any income or resources to which they may be entitled. Recipients of
				  supplemental security income (SSI) or aid to families with dependent children
				  (AFDC) who apply for QMB are excluded from this requirement. A victim of crime
				  is not required to accept victim compensation payments from a
				  state-administered fund established to aid crime victims as a condition of
				  eligibility.