New Mexico Register / Volume
XXXIV, Issue 15 / August 15, 2023
This is an
amendment to 5.7.3 NMAC Sections 6, 7, 9, 11 and 12 effective
8/15/2023.
5.7.3.6 OBJECTIVE: The objective and
purpose of 5.7.3 NMAC is to increase the number of health professionals in
underserved areas of the state through a program of loan repayment of eligible
educational loans. The program will pay
its participants for the principal and reasonable interest accrued on loans
obtained for educational purposes. The
program requires, as a condition of each eligible participant, that they
practice their profession within one of the areas of the state designated by
the health profession advisory committee as a health professional shortage area
for a minimum period of [two] three years.
[7/15/1998;
5.7.3.6 NMAC - Rn, 5 NMAC 7.3.6, 7/31/2005; A, 8/15/2023]
A. ["Department"] "Commission", without further specification, means
the New Mexico higher education department.
B. "Committee"
means the health professions advisory committee of the department.
C. "Department" means the New Mexico
higher education department.
[C] D. "Eligible educational loan" means
government and commercial loans for actual costs paid for tuition, reasonable
education expenses including fees, books, supplies and materials; and
reasonable living expenses including room and board and other itemized expenses
incurred during an individual's enrollment at a post-secondary institution in a
health occupation educational program.
Expenses incurred must be related to the acquiring of said education.
[D] E. "Eligible participant" includes
[primary care] physicians, physician assistants, advanced practice
nurses, registered nurses, dentists, [pediatrists] podiatrists, [optometrists
and allied health care providers. Other
specialties may be considered at the discretion of the committee.] optometrists,
allied health care providers and other specialties approved by the committee.
[E] F. "Extenuating circumstances" means
circumstances not within the control of the recipient.
[F] G. "Health professional shortage
area" means an area of the state or a facility which has been
determined by the health professions advisory committee as an acceptable
practice site in which program participants may fulfill their commitment.
[G] H. "[Primary care physician] Physician"
means a physician, allopathic or osteopathic with a specialty in family or
general medicine, general internal medicine, general pediatrics and obstetrics
and gynecology [Other] and other specialties [may be
considered at the discretion of] approved by the committee.
[7/15/1998; 5.7.3.7 NMAC - Rn
& A, 5 NMAC 7.3.7, 7/31/2005; A, 5/16/2023; A, 8/15/2023]
5.7.3.9 PARTICIPANT ELIGIBILITY:
To be eligible for this program, an applicant must:
A. submit an
application containing biographical, educational and health profession
education loan information including lender name, address, telephone number,
loan numbers, loan balances, interest rates and remaining payments for review;
B. be licensed or
certified in the state of New Mexico to practice their profession;
C. be a citizen of
the United States or a permanent resident alien and a resident of New Mexico;
D. provide service
in a clinical practice of their profession full time (36 hours per week), the
committee may consider part-time service, with prorated awards, on a
case-by-case basis;
E. practice in an
approved health professional shortage area for a minimum period of [two]
three years, the committee may consider longer periods of service on a
case-by-case basis;
F. charge for their
professional services at the usual and customary rates prevailing in the areas
in which such services are provided, except that if a person is unable to pay
such a charge, such person shall be charged at a reduced rate or not charged
any fee;
G. agree that, in
providing health services, they will not, in the case of an individual seeking
care, discriminate on the basis of the ability of the individual to pay for
such care or on the basis that payment for such care will be made pursuant to
the program established in Title XVIII (medicare) of
the Social Security Act or pursuant to the program established in Title XIX (medicaid) of such act; and
H. agree that they
will accept assignment under Section 1842(b)(3)(B)(ii) of the Social Security act
for all services for which payment may be made under Part B of Title XVIII and
will enter into an appropriate agreement with the state agency that administers
the state plan for medical assistance under Title XIX of such act to provide
service to individuals entitled to medical assistance under the plan.
[7/15/1998;
5.7.3.9 NMAC - Rn, 5 NMAC 7.3.9, 7/31/2005; A, 5/16/2023; A, 8/15/2023]
5.7.3.11 PARTICIPATION AGREEMENT:
Upon approval, a participation agreement shall be drawn between each
eligible participant receiving loan repayment and the department on
behalf of the state of New Mexico. The
agreement shall state both the participant's obligation under the program as
well as the department’s responsibility. No payment will be made until a duly signed
document is on file at the department
offices. The participation agreement
shall include, but not be limited to, the following stipulations:
A. provide for the
repayment of a specified sum as determined in Section 10; the commission will
pay the amount due for each quarter of completed service by the program
participant, directly to the participant or their lender(s) for payment of
their health professional education loans; any amounts allocated to repay loans
will be divided equally by the number of quarters in the service period covered
by the award; quarters comprise an average of thirteen weeks including paid
leave or any combination of hours and weeks thereof for the entire service
period;
B. state that the department will
complete annual reports to all tax authorities delineating award payments made
to the program participant;
C. state that
payment of the award is conditioned upon the program participant submitting
timely reports and requests for reimbursement to the department or its
designee, as required by the commission;
D. state the
participant's obligations including a minimum [two] three year
period of service in a practice providing continuous clinical services in the
field of their profession in an area designated by the committee as eligible;
E. state that the
program participant is responsible for payment(s) of their eligible health
professional education loans until such time that actual loan repayment is
performed by the department. Repayment by the department will begin following the first certified quarter of
completed clinical service in an area designated by the committee;
F. state that the
recipient will charge for professional services at the usual and customary rate
prevailing in the area where the services are provided, except that if a person
is unable to pay such charge, such person shall be charged at a reduced rate or
not charged any fee;
G. in providing
health services, the participant shall not discriminate against any person on
the basis of such person's ability to pay for such services or because payment
for the health services provided to such person will be made under the
insurance program established under Part A or B of Title XVIII of the Social
Security Act or under a state plan for medical assistance approved under Title
XIX of such act;
H. the participant
will accept assignment under Sections 1842(b)(3)(B)(ii) of the Social Security
Act for all services for which payment may be under Part B of Title XVIII of
such act and enter into an appropriate agreement with the state agency which
administers the state plan for medical assistance under Title XIX of such act
to provide services to individuals entitled to medical assistance under the
plan;
I. the award will
be terminated if any of the following should occur:
(1) the
participant fails to perform continuous clinical service at the approved
facility, unless a change of facility or an interruption in service is approved
in advance and in writing by the department; no interruption in service exceeding six months will be
approved;
(2) the
employment of the participant at an approved location is terminated;
(3) the
participant loses their professional license, board certification or billing
privileges for medicaid or medicare;
or
(4) the
department deems termination is warranted for any other reasonable
cause.
J. in the event
this agreement is terminated by the commission, the commission shall have no
obligation to make any further payments to or on behalf of the participant;
K. penalties as outlined
in Section 12; and
L. shall state that
the participant further promises:
(1) to
use the allocated award solely for the purposes of repaying health professional
education loans, including principal, interest and related expenses or, where
approved by the commission;
(2) to
be responsible for all tax liabilities incurred in the acceptance of the award;
and
(3) to
complete all necessary reports and requests for loan repayment required by
commission and submit them to the commission or its designee on a timely basis.
[7/15/1998;
5.7.3.11 NMAC - Rn & A, 5 NMAC 7.3.11, 7/31/2005; A, 12/11/2018; A,
8/15/2023]
5.7.3.12 PENALTIES:
A. If a program
participant does not comply with the terms of the participation agreement, the department shall
assess a penalty of up to three times the amount of award disbursed, plus
eighteen percent interest, unless the commission finds acceptable extenuating
circumstances for why the participant could not serve and comply with the terms
of the provisions. If the commission
does not find acceptable extenuating circumstances for the participant's
failure to comply, the commission shall require immediate repayment plus the
amount of any penalty assessed pursuant to this section.
(1) The
full penalty shall apply unless the circumstances reflect that the penalty
should be reduced on a prorata basis reasonably
reached based upon the degree of control which the recipient has over the
decision not to serve. The recipient shall have the burden of proof.
(2) If
the commission does not find acceptable extenuating circumstances for the
recipient's failure to carry out their declared intent to serve in a designated
shortage area in the state, the commission shall require immediate repayment of
the award granted to the recipient plus the amount of any penalty assessed
pursuant to this subsection.
B. Participants who
have signed a participation agreement for [two] three years and
fail to complete a quarter of service will not receive a prorated award amount.
[7/15/1998;
5.7.3.12 NMAC - Rn & A, 5 NMAC 7.3.12, 7/31/2005; A, 8/15/2023]