New
Mexico Register / Volume XXXII, Issue 20 / October 26, 2021
NOTICE
OF RULEMAKING
The Human Services Department (the
Department), through the Medical Assistance Division (MAD), issued emergency
rule changes to New Mexico Administrative Code (NMAC) rule 8.100.970, General
Provisions for Public Assistance Programs, Oversight-Program Participation
Hearings on October 26, 2021 with an effective date of November 1,
2021. The Department is re-promulgating
this rule in full within six months of issuance of the emergency rule in
accordance with the New Mexico State Rules Act.
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 26, 2021
Hearing Date: November 30, 2021
Adoption Date: Proposed as March 1, 2022
Technical Citations: 45 CFR 155 subpart F
The Department is proposing to amend the rule
as follows:
Background
New
Mexico’s Health Insurance Exchange (NMHIX; aka beWellnm) is transitioning from
utilizing the federal IT platform of Healthcare.gov to a state-based IT
platform. Given this transition, HSD
must collaborate with beWellnm on IT and program integration. One aspect of program integration pertains to
appeals rights for adverse actions impacting an enrollee’s eligibility for
qualified health plans through NMHIX, federal tax credits and cost-sharing
reductions, and other issues pertaining to NMHIX coverage. While using the federal Healthcare.gov
platform, NMHIX has been working with the federal government on such appeals,
when necessary. With the move to a state-based platform, NMHIX has requested
that HSD take on the role of providing first tier appeals of adverse actions by
enrollees. Thus, HSD must promulgate
rules pertinent to providing those appeals for NMHIX enrollees or potential
enrollees.
The Department is proposing to amend the rule
as follows:
8.100.970 - NMAC-General Provisions for Public
Assistance Programs – Oversight-Program Participation Hearings.
This rule is being updated to integrate functions of
providing first tier appeals for New Mexicans purchasing coverage through New
Mexico’s Health Insurance Exchange (NMHIX; aka beWellnm).
The
register for these proposed amendments to this rule will be available October
26, 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 rule may be requested by contacting MAD in Santa Fe at 505-827-1337.
The Department proposes to implement this rule
effective March 1, 2022. A public hearing to receive testimony on this
proposed rule will be held via conference call on November 30,
2021 at 10:00 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.