New Mexico Register / Volume
XXIX, Issue 19 / October 16, 2018
NOTICE
OF RULEMAKING
The Human Services Department (the
Department), through the Medical Assistance Division (MAD), is proposing to
amend the New Mexico Administrative Code (NMAC) rule 8.201.400 NMAC - Medicaid Eligibility-Medicaid Extension Categories,
8.215.400 NMAC - SSI Methodology-Recipient Policies, and 8.281.400 NMAC -
Institutional Care-Recipient Policies.
Section 9-8-6 NMSA 1978,
authorizes the Department Secretary to promulgate rules and regulations that
may be necessary to carry out the duties of the Department and its divisions.
Notice Date: October 16, 2018
Hearing Date: November 14, 2018
Adoption Date: Proposed as January 1, 2019
Technical Citations: SMD Letter, POMS, 42 CFR 435.1010
Summary of Revisions:
As part
of the rule promulgation 8.201.400, 8.215.400, and 8.281.400 NMAC are being
repealed and replaced to comply with formatting requirements.
8.201.400 NMAC – Medicaid Eligibility –
Medicaid Extension
The
Department proposes to amend Section 9 to clarify that the Supplemental
Security Income (SSI) extension categories are 001, 003, and 004.
The
Department proposes to amend Section 10 to delete redundant language and to
replace the outdated reference to the “disability determination services (DDS)”
with the “disability determination unit (DDU)” throughout these rules. The outdated term “Income Support Specialist
(ISS)” was replaced with “Income Support Division worker” throughout these
rules.
The
Department proposes to amend Paragraph (1) of Subsection G of Section
8.201.400.10 NMAC to allow certain recipients of SSI who become ineligible for
SSI cash benefits to be automatically extended Medicaid benefits for an
additional two months following the month in which SSI closes, as opposed to
the current one-month policy.
Current
language at Paragraph (2) of Subsection G of Section 8.201.400.10 NMAC allows
for extended Medicaid for five SSI closure codes. The Department proposes to
amend this language to allow for two months of extended Medicaid for 31 SSI
closure codes.
The
Department proposes to delete language at Subparagraph (a) and (b) of Paragraph
(1) of Subsection G of Section 8.201.400.10 NMAC regarding requiring an application
for a second one-month extension of Medicaid, since these individuals will
automatically receive two months of extended Medicaid under the new rule. Additionally, the Department proposes to add
new language implementing an ex-parte process to systematically evaluate
two-month extended SSI clients for other Medicaid categories during their
extension period.
The
Department proposes to delete language at Subsection H of Section 8.201.400.10
NMAC regarding children terminated from SSI solely due to disability criteria
implemented by the Personal Responsibility and Work Opportunity Reconciliation
Act of 1996 (PRWORA) because all of these individuals have aged out of the
category. This regulatory language is no
longer relevant.
The
Department proposes to amend Section 12 enumeration language to refer to
8.200.410.10 NMAC, which is the correct citation.
8.215.400 NMAC – Medicaid Eligibility –
Supplemental Security Income
The
Department proposes to add a new section at 8.215.400.10 NMAC regarding coverage
of Section 1619(b) recipients. The new
proposed language clarifies that the Department has a 1634 Agreement with the
Social Security Administration (SSA) under which the SSA makes Medicaid
eligibility determinations for both SSI and 1619(b) recipients. These individuals automatically have Medicaid
eligibility unless they fail to meet the assignment of rights or third party
liability requirements; or unless the Department has determined ineligibility
under the Medicaid trust provision.
8.281.400 NMAC – Medicaid Eligibility –
Institutional Care
Current
language at Section 10 requires that an applicant/recipient be in a “Medicaid
qualifying” bed in a New Mexico Medicaid approved institution for Institutional
Care (IC) Medicaid. A proposed revision
was added to include hospitals administered by the US Department of Veteran’s
Affairs (VA) as Medicaid approved institutions.
This proposed change will allow VA hospital patients who are preparing
to transition out of the acute care hospital into an IC setting of care to have
their IC Medicaid applications evaluated for eligibility sooner. This will reduce delays in application
processing for VA hospital patients transitioning to IC settings.
The
Department proposes to amend language at Section 11 to replace “ISD caseworker”
with “Income Support Division worker” throughout these rules.
The
Department proposes to amend Section 12 enumeration language to refer to the
general recipient provisions found at 8.200.410.10 NMAC.
The
Department proposes to amend Section 17 to replace the outdated reference to
the “disability determination services (DDS)” with the “disability
determination unit (DDU)” throughout these rules.
The
register for these proposed amendments to the rule will be available September
11, 2018 on the HSD website at http://www.hsd.state.nm.us/LookingForInformation/registers.aspx or at http://www.hsd.state.nm.us/public-notices-proposed-rule-and-waiver-changes-and-opportunities-to-comment.aspx. If you do not have Internet access, a copy of
the proposed rule may be requested by contacting MAD in Santa Fe at
505-827-6252.
The
Department proposes to implement these rules effective January 1, 2019. A public hearing to receive testimony on
these rules will be held in Hearing Room 2, Toney Anaya Building, 2550 Cerrillos Road, Santa Fe, New
Mexico, 87505 on November 14, 2018 from 10 a.m. to 11 a.m., Mountain Standard
Time (MST).
Interested
parties may submit written comments directly to: Human Services Department, Office of the
Secretary, ATT: Medical Assistance Division Public Comments, P.O. Box 2348,
Santa Fe, New Mexico 87504-2348.
Recorded
comments may be left by calling (505) 827-1337.
Electronic comments may be submitted to madrules@state.nm.us. Written, electronic and recorded comments
will be given the same consideration as oral testimony made at the public
hearing. All comments must be received
no later than 5:00 p.m. MDT, November 15, 2018.
All written comments received will be posted as they are received on the
HSD website at http://www.hsd.state.nm.us/2017-comment-period-open.aspx along
with the applicable register and rule.
The public posting will include the name and any contact information
provided by the commenter.
If
you are a person with a disability and you require this information in an
alternative format or require a special accommodation to participate in the
public hearing, please contact MAD in Santa Fe at 505-827-6252. The Department requests at least ten (10)
days advance notice to provide requested alternative formats and special
accommodations.
Copies
of all comments will be made available by the MAD upon request by providing
copies directly to a requestor or by making them available on the MAD website or
at a location within the county of the requestor.