TITLE 8 SOCIAL SERVICES
CHAPTER 172 PREMIUM
ASSISTANCE FOR MATERNITY (CATEGORY 035/2)
PART 600 BENEFIT
DESCRIPTION
8.172.600.1 ISSUING
AGENCY: Human Services Department
[8.172.600.1 NMAC - N/E,
12-31-06]
8.172.600.2 SCOPE: This rule
applies to the general public.
[8.172.600.2 NMAC - N/E,
12-31-06]
8.172.600.3 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 pregnant women ineligible for
federally funded public assistance. The
premium assistance for maternity program will be designated for purposes of
this policy as category 035/2.
[8.172.600.3 NMAC - N/E,
12-31-06]
8.172.600.4 DURATION: The medical or
premium assistance program is operated subject to the availability of funding.
[8.172.600.4 NMAC - N/E,
12-31-06]
8.172.600.5 EFFECTIVE
DATE: December 31, 2006, unless a later date is
cited at the end of the section.
[8.172.600.5 NMAC - N/E,
12-31-06]
8.172.600.6 OBJECTIVE: The objective
of premium assistance for maternity is to reduce the number of uninsured New
Mexicans by providing state funds toward the purchase of comprehensive health
insurance products for pregnant women who are ineligible for public assistance
under the act.
[8.172.600.6 NMAC - N/E,
12-31-06]
8.172.600.7 DEFINITIONS: See 8.172.400
NMAC.
[8.172.600.7 NMAC - N/E,
12-31-06]
8.172.600.8 [RESERVED]
8.172.600.9 BENEFITS: The premium assistance
for maternity (PAM) benefit is premium assistance toward the purchase of pregnancy-related
health coverage. The portion of the
one-time premium paid by the PAM program will be determined by the secretary of
the human services department, based on available funding. The one-time premium payment is constructed
to provide financial incentives for early prenatal care.
[8.172.600.9 NMAC - N/E,
12-31-06]
8.172.600.10 [RESERVED]
8.172.600.11 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.
[8.172.600.11 NMAC - N/E,
12-31-06]
8.172.600.12 RIGHTS
TO APPEAL: The human services department will grant an
opportunity for an administrative hearing when an applicant or recipient
believes that HSD has taken an action erroneously regarding eligibility for the
premium assistance program as described in 8.352.2 NMAC.
[8.172.600.12 NMAC - N/E,
12-31-06]
HISTORY OF 8.172.600
NMAC:
[RESERVED]