New
Mexico Register / Volume XXXII, Issue 16 /August 24, 2021
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 8.200.400 NMAC - General
Recipient Rules-General Medicaid Eligibility, 8.200.410 NMAC - General
Recipient Rules-General Recipient Requirements, 8.231.400 NMAC - Medicaid
Eligibility-Infants of Mothers Who Are Medicaid Eligible Recipient Policies,
8.231.600 NMAC - Medicaid Eligibility-Infants of Mothers Who Are Medicaid
Eligible Benefit Description, 8.234.400 NMAC - Medicaid Eligibility-SSI
Ineligibility-Due to Income or Resources from an Alien Sponsor Recipient
Requirements, 8.234.500 NMAC - Medicaid Eligibility-SSI Ineligibility - Due to
Income or Resources from an Alien Sponsor, Income and Resource Standards,
8.243.400 NMAC-Medicaid Eligibility-Working Disabled Individuals Recipient
Policies, 8.249.400 NMAC - Medical Assistance Program Eligibility-Refugee
Medical Assistance Program Recipient Requirements, 8.249.500 NMAC - Medical
Assistance Program Eligibility -Refugee Medical Assistance Program, Income and
Resource Standards, 8.250.400 NMAC - Medical Assistance Program
Eligibility-Qualified Disabled Individuals, Recipient Policies, 8.252.400 NMAC -
Medicaid Eligibility Breast and Cervical Cancer Program, 8.280.400 NMAC - Medicaid
Eligibility-Program of All-Inclusive Care for the Elderly (PACE), Recipient
Policies, 8.285.400 NMAC - Medicaid Eligibility-Emergency Medical Assistance
For Aliens Recipient Requirements, 8.285.500 NMAC - Medicaid Eligibility-Emergency
Medical Services for Aliens, Income And Resource Standards, 8.285.600 NMAC - Medicaid
Eligibility-Emergency Medical Services for Aliens, Benefit Description,
8.291.410 NMAC-Medicaid Eligibility - Affordable Care General Recipient Requirements,
8.292.500 NMAC - Medicaid Eligibility-Parent Caretaker Recipient Income and
Resource Standards, 8.293.500 NMAC - Medicaid Eligibility-Pregnant Women
Recipient Income and Resource Standards, 8.294.500 NMAC - Medicaid
Eligibility-Pregnancy-Related Services Recipient Income and Resource Standards,
8.295.500 NMAC - Medicaid Eligibility-Children Under 19 Recipient Income and
Resource Standards, 8.296.500 NMAC - Medicaid Eligibility-Other Adults
Recipient Income and Resource Standards, 8.299.500 NMAC - Medicaid Eligibility-
Family Planning Services Recipient Income And Resource Standards, and 8.325.10
NMAC - Specialty Services-Emergency Medical Services For Aliens.
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: August 24, 2021
Hearing Date: September 24, 2021
Adoption Date: Proposed as
January 1, 2022
Technical Citations: Section 208
of the Consolidated Appropriations Act, 2021; 42 Code of Federal Regulation
435.603(h)(2)
The Department is proposing to amend the
rule as follows:
Background
The Centers for
Medicare and Medicaid Services (CMS) has indicated that the use of the term
“alien” is outdated and should be replaced with the term “non-citizen.” The Department is proposing rule changes to
change “alien” to “non-citizen” throughout our rules.
Effective December 27, 2020, section 208 of the Consolidated
Appropriations Act, 2021 requires states and the District of Columbia (DC) to
provide Medicaid coverage for individuals who are considered Compact of Free
Association (COFA) migrants (also referred to as compact citizens). COFA is an agreement between the United
States and the three Pacific Island sovereign states of Federated States of
Micronesia, the Republic of the Marshall Islands, and the Republic of Palau,
known as Freely Associates States.
States must cover COFA migrants in Medicaid as “qualified non-citizens”
without a 5-year waiting period, if otherwise eligible under the Medicaid state
plan or section 1115 demonstration. The
Department is updating citizenship rules to include COFA migrants as “qualified
non-citizens” exempt from the 5-year waiting period.
The Department is
proposing additional rule changes to no longer require an interview for Program
of All-Inclusive Care for the Elderly (PACE) applicants, and update the “Income
Eligibility” section for Modified Adjusted Gross Income (MAGI) Medicaid
categories to remove outdated language, make the language consistent, and
clarify that the Department uses current monthly income in accordance with 42
Code of Federal Regulations 435.603(h)(2).
The Department is proposing to amend these
rules as follows:
8.200.400,
8.200.410, 8.231.400, 8.231.600, 8.234.400, 8.234.500, 8.243.400, 8.249.400,
8.249.500, 8.250.400, 8.252.400, 8.285.400, 8.285.500, 8.285.600, 8.291.410 and
8.325.10 NMAC.
These rules are
being updated to change the term “alien” to ‘non-citizen” throughout.
8.200.410 NMAC
Section 11
citizenship is being updated to incorporate the new COFA requirements.
8.280.400 NMAC:
Section 11 of the
PACE rules are being updated to clarify that an interview is not required in
accordance with Institutional Care rules found at 8.281.400.11.
8.292.500,
8.293.500, 8.294.500, 8.295.500, 8.296.500, 8.299.500 NMAC:
Section 12 is
updated to remove outdated language, inconsistent language across Medicaid
categories, and clarify that income eligibility for Parent/Caretaker, Pregnant
Women, Pregnancy-Related Services, and Children under 19 Medicaid categories
use modified adjusted gross income methodology using current monthly income,
per State option, as opposed to projected annual household income per 42 Code
of Federal Regulations 435.603(h)(2).
The state defines current monthly income as a 30-day period.
Section 11 for
Other Adult and Family Planning Medicaid categories is updated to reflect the
same language changes cited in the prior paragraph above for consistency.
8.200.400,
8.200.410, 8.231.400, 8.231.600, 8.234.400, 8.234.500, 8.243.400, 8.249.400,
8.249.500, 8.250.400, 8.252.400, 8.285.500, 8.291.410, 8.292.500, 8.293.500,
8.294.500, 8.295.500, 8.296.500, 8.299.500 NMAC.
Section 8 is
being updated to include the Department’s mission statement.
Throughout all
the proposed rules amendments have been made to address formatting
requirements.
The register for these proposed amendments to these rules will be
available August 24, 2021 on the HSD web site at https://www.hsd.state.nm.us/lookingforinformation/registers/ or at https://www.hsd.state.nm.us/public-information-and-communications/opportunity-for-public-comment/public-notices-proposed-waiver-changes-and-opportunities-to-comment/comment-period-open/. If you do not have Internet access, a copy of
the proposed rules may be requested by contacting MAD in Santa Fe at 505-827-1337.
The Department proposes to implement these rules effective January 1,
2022. A public hearing to receive
testimony on these proposed rules will be held via conference call on Friday,
September 24, 2021 at 9 a.m., Mountain Time (MT). Conference
phone number: 1-800-747-5150. Access Code:
2284263.
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.
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 505-827-1337. 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.