TITLE 8                 SOCIAL SERVICES




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]