TITLE 8 SOCIAL SERVICES

CHAPTER 171 PREMIUM ASSISTANCE FOR CHILDREN (CATEGORY 071/2)

PART 600 BENEFIT DESCRIPTION

8.171.600.1 ISSUING AGENCY: Human Services Department

[8.171.600.1 NMAC - N/E, 8-31-06]

8.171.600.2 SCOPE: This rule applies to the general public.

[8.171.600.2 NMAC - N/E, 8-31-06]

8.171.600.3 STATUTORY AUTHORITY: New Mexico Statutes Annotated, 1978 (Chapter 27, Article 2-12) authorizes the human services department to administer a program of medical or premium assistance for children and pregnant women ineligible for federally funded public assistance. The premium assistance for kids program will be designated for purposes of this regulation as category 071.

[8.171.600.3 NMAC - N/E, 8-31-06]

8.171.600.4 DURATION: Permanent.

[8.171.600.4 NMAC - N/E, 8-31-06]

[The medical or premium assistance program is operated subject to the availability of funding.]

8.171.600.5 EFFECTIVE DATE: August 31, 2006, unless a later date is cited at the end of the section.

[8.171.600.5 NMAC - N/E, 8-31-06]

8.171.600.6 OBJECTIVE: The objective of premium assistance is to reduce the number of uninsured New Mexicans by providing state funds toward the purchase of comprehensive health insurance products to children up to the age of twelve, and children up to the age of eighteen if part of a sibling group that includes a child up to the age of twelve, who are ineligible for public assistance under the act.

[8.171.600.6 NMAC - N/E, 8-31-06]

8.171.600.7 See 8.171.400.7 NMAC.

[8.171.600.7 NMAC - N/E, 8-31-06]

8.171.600.8 [RESERVED]

8.171.600.9 BENEFITS: The premium assistance for kids benefit is premium assistance toward the purchase of a comprehensive health insurance plan that is certified by the human services department. The portion of the health insurance premium that is paid by the premium assistance for kids program is determined by the secretary of the human services department, based on available funding.

[8.171.600.9 NMAC - N/E, 8-31-06]

8.171.600.10 [RESERVED]

8.171.600.11 ERRONEOUS RECEIPT OF PREMIUM ASSISTANCE PROGRAM BENEFITS: Participants of the premium assistance program who failed to provide pertinent information or who provided false information regarding eligibility will be responsible for repayment of benefits that were erroneously received.

[8.171.600.11 NMAC - N/E, 8-31-06]

8.171.600.12 RIGHTS TO APPEAL: The human services department will grant an opportunity for an administrative hearing when an applicant or recipient believes that the human services department has taken an action erroneously regarding eligibility for the premium assistance program as described in 8.352.2 NMAC.

[8.171.600.12 NMAC - N/E, 8-31-06]

HISTORY OF 8.171.600 NMAC: [RESERVED]