New
Mexico Register / Volume XXXII, Issue 22 / November 30, 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)
rules 8.291.400 NMAC, Medicaid Eligibility, Affordable Care, 8.293.600 NMAC,
Pregnant Women, Benefit Description, 8.294.600 NMAC, Pregnancy-Related
Services, Benefit Description, 8.308.9 NMAC, Managed Care Plan, Benefit
Package, 8.308.11 NMAC, Managed Care Plan, Transition of Care, 8.308.20 NMAC,
Managed Care Plan, Reimbursement, 8.310.2 NMAC, Health Care Professional
Services, General Benefit Description, and 8.326.3 NMAC, Case Management
Services, Case Management Services for Pregnant Women and their Infants.
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: November 30, 2021
Hearing Date: December 30, 2021
Adoption Date: Proposed as April 1, 2022
Technical Citations: American Rescue Plan Section 2021 Section
9812; 42 Code of Federal Regulations 435.170
The Department is proposing to amend the rules
as follows:
Background
Section 9812 of the American Rescue Plan 2021
provides a new Medicaid State Plan option that allows states to extend the
current 60-day postpartum period for pregnant women to 12-months. Section 9812 allows states to do the
following:
1.
Extends the current 60-day postpartum period for pregnant women to
12-months; and
2.
provides full Medicaid benefits during the pregnancy and the 12-month
postpartum period; and
3.
allows for an implementation date of April 1, 2022; and
4.
limits the new State Plan option to five years unless extended.
The
Department through this proposed register is implementing the new State Plan
option allowed in Section 9812. The
Department is also adding 42 Code of Federal Regulation (CFR) 435.170 language
to these rules regarding continuous eligibility for pregnant women.
Implementation of a 12-month postpartum period
for pregnant women is contingent upon legislative approval.
Changes
were made to Presumptive Eligibility (PE) rules to remove, revise, and add new
language.
Changes
were made to managed care rules to include that there are no age
requirements to receive applied behavior analysis (ABA) services.
Section
7 was updated to remove the word “alien” to be consistent with other rule
changes. The term “alien” is being
replaced with the term “non-citizen” throughout policy via a separate rule
promulgation.
Section
13 regarding PE is updated to remove, revise. and add new language. New language is added that if an ongoing
application is submitted at the time PE is granted or at any time during the
approved PE period, the PE will remain open until the ongoing application is
approved or denied.
A new Section 14 is added to
include the continuous eligibility policy for pregnant women language found at
42 CFR 435.170 and the new 12-month postpartum provision. The new provision requires the provision of
full Medicaid coverage for the duration of the pregnancy including the 12-month
postpartum period. These new provisions
do not apply to presumptive eligibility periods. Continuous eligibility exceptions are due to
client requested closure, the client moves out of state, or the client dies.
8.293.600
NMAC
Section 9 is updated to clarify
that the pregnant women Medicaid category provides full Medicaid services
during the pregnancy and the 12-month postpartum period.
Section 10 is updated to change the
60-day postpartum period to 12-months and reference the new continuous
eligibility policy at 8.291.400.14 NMAC.
8.294.600
NMAC
Section 9 is updated to clarify
that the pregnancy-related services Medicaid category provides full Medicaid
services during the pregnancy and the 12-month postpartum period.
Section 10 is updated to change the
60-day postpartum period to 12-months and reference the new continuous
eligibility policy at 8.291.400.14 NMAC.
8.308.9
NMAC
Section 19 is updated to include
that there are no age requirements to receive ABA services.
Section 23
Paragraph (2) of Subsection C is
updated to change the 60-day postpartum period to 12-months.
8.308.11
NMAC
Section 9
Paragraphs (1), (3) and (4) of Subsection
D and Paragraph (2) of Subsection F are updated to change two-month postpartum
period to 12-months.
8.308.20
NMAC
Section 9
Paragraph (4) of Subsection F is
updated to change the two-month postpartum period to 12-months.
8.310.2
NMAC
Section 12
Paragraph (4) of Subsection A is updated
to change the term “postnatal” to “postpartum” for rule consistency.
Section 13
Subsection N is revised to make
postpartum one word.
8.326.3
NMAC
Sections
9 and 12 are updated to change 60 days postpartum to 12-months.
Changes
have been made throughout all these rules to address formatting requirements.
The
register for these proposed amendments to these rules will be available November
30, 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 April 1, 2022. A public
hearing to receive testimony on these proposed rules will be held via
conference call on Thursday, December 30, 2021 at 10 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.