New Mexico Register / Volume XXXI, Issue 8 / April 21, 2020
This is an amendment to 8.285.400 NMAC, sections 8-10 and
12-14, effective 5/1/2020.
8.285.400.8 MISSION: [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.] 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.
[8.285.400.8 NMAC - N, 1/1/2014; A, 5/1/2020]
8.285.400.9 EMERGENCY
MEDICAL SERVICES FOR ALIENS - CATEGORY 085: Certain non-citizens who
are undocumented or who do not meet the qualifying immigration criteria
specified in 8.200.410 NMAC, but who meet all eligibility criteria for [other
medical assistance program categories 030, 032, 035, 072, 100, 200, 300,
301, 400, 420 and or supplemental security income (SSI)] the following
medical assistance categories of eligibility (COEs): other adults (COE 100), parent/caretaker (COE
200), pregnant women (COE 300), pregnancy-related services (COE 301), children
under age 19 (COEs 400, 401, 402, 403, 420, and 421) or supplemental security
income (COEs 001, 003, and 004) can receive coverage for emergency services. See 42 CFR Section 440.225.
[8.285.400.9 NMAC - Rp, 8.285.400.9 NMAC, 1/1/2014; A, 5/1/2020]
8.285.400.10 BASIS
FOR DEFINING THE GROUP: [The determination of emergency
status is made by the medicaid utilization review
contractor. For purposes of determining
emergency status, the following definition applies: an emergency condition means a medical or
behavioral health condition manifesting itself through acute symptoms of
sufficient severity (including severe pain) such that a prudent layperson with
average knowledge of health and medicine could reasonably expect the absence of
immediate medical attention to result in the health of the individual or with
respect to a pregnant woman, the health of the woman or her unborn child to
result in serious jeopardy; serious
impairment to the individual’s bodily functions; or serious dysfunction of any
of his or her bodily organs or parts. With
respect to a pregnant woman and her unborn child, emergency services includes
all emergency labor and delivery services, such as inductions of labor and caesarean
sections.] The definition of an
emergency medical condition is found at 8.325.10.13 NMAC.
[8.285.400.10 NMAC - Rp, 8.285.400.10 NMAC, 1/1/2014; A, 5/1/2020]
8.285.400.12 ENUMERATION: [An alien] A
non-citizen applicant is exempt from the requirement to provide a social
security number (SSN). If the applicant
is found eligible for coverage of emergency services, the claims are paid using
[a dummy number. Issuance of the
dummy number is done on the current eligibility system.] an eligibility
system generated identification number.
[8.285.400.12 NMAC - Rp, 8.285.400.12 NMAC, 1/1/2014; A, 5/1/2020]
8.285.400.13 CITIZENSHIP: An applicant must be a [noncitizen] non-citizen
who is undocumented or who does not meet the qualifying immigration criteria
specified in 8.200.410 NMAC. Per
42 CFR 440.255(c), effective January 1, 1987, non-citizens who are not lawfully
admitted for permanent residence in the United States or permanently residing
in the United States under the color of law must receive the services necessary
to treat the condition defined at 8.325.10.13 NMAC.
[8.285.400.13 NMAC - Rp, 8.285.400.13 NMAC, 1/1/2014; A, 5/1/2020]
8.285.400.14 RESIDENCE:
[ An applicant must provide proof of New Mexico residence. Undocumented aliens traveling through New
Mexico, visiting in New Mexico, or touring New Mexico do not meet the residence
requirements for eligibility.] An applicant must be a resident of the
state of New Mexico in accordance with 8.200.410.14 and 8.291.410.15 NMAC.
[8.285.400.14 NMAC - Rp, 8.285.400.14 NMAC, 1/1/2014; A, 5/1/2020]