TITLE 8 SOCIAL SERVICES

CHAPTER 294 MEDICAID ELIGIBILITY - PREGNANCY-RELATED SERVICES

PART 600 BENEFIT DESCRIPTION

 

8.294.600.1 ISSUING AGENCY: New Mexico Human Services Department (HSD).

[8.294.600.1 NMAC - Rp, 8.294.600.1 NMAC, 1/1/2019]

 

8.294.600.2 SCOPE: The rule applies to the general public.

[8.294.600.2 NMAC - Rp, 8.294.600.2 NMAC, 1/1/2019]

 

8.294.600.3 STATUTORY AUTHORITY: The New Mexico medicaid program is administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act as amended or by state statute. See Section 27-1-12 et seq., NMSA 1978.

[8.294.600.3 NMAC - Rp, 8.294.600.3 NMAC, 1/1/2019]

 

8.294.600.4 DURATION: Permanent.

[8.294.600.4 NMAC - Rp, 8.294.600.4 NMAC, 1/1/2019]

 

8.294.600.5 EFFECTIVE DATE: January 1, 2019, or upon a later approval date by the federal centers for medicare and medicaid services (CMS), unless a later date is cited at the end of the section.

[8.294.600.5 NMAC - Rp, 8.294.600.5 NMAC, 1/1/2019]

 

8.294.600.6 OBJECTIVE: The objective of this rule is to provide eligibility guidelines when determining eligibility for the medical assistance division (MAD) medicaid program and other health care programs it administers. Processes for establishing and maintaining this category of eligibility are found in the affordable care general provision chapter located at 8.291.400 NMAC through 8.291.430 NMAC.

[8.294.600.6 NMAC - Rp, 8.294.600.6 NMAC, 1/1/2019]

 

8.294.600.7 DEFINITIONS: Refer to 8.291.400.7 NMAC.

[8.294.600.7 NMAC - Rp, 8.294.600.7 NMAC, 1/1/2019]

 

8.294.600.8 MISSION: To transform lives. Working with our partners, we design and deliver innovative, high quality health and human services that improve the security and promote independence for New Mexicans in their communities.

[8.294.600.8 NMAC - Rp, 8.294.600.8 NMAC, 1/1/2019; A, 4/5/2022]

 

8.294.600.9 BENEFIT DESCRIPTION: This category provides the full range of Medicaid coverage for the duration of the pregnancy and for the 12-month postpartum period.

[8.294.600.9 NMAC - Rp, 8.294.600.9 NMAC, 1/1/2019; A, 4/5/2022]

 

8.294.600.10 BENEFIT DETERMINATION: The HSD income support division (ISD) determines initial and ongoing eligibility. Refer to affordable care general provision chapters located at 8.291.400 through 8.291.430 NMAC for eligibility requirements. An individual eligible for pregnancy-related services medicaid remains eligible throughout the pregnancy and for a 12-month postpartum period in accordance with 8.291.400.14 NMAC. Retroactive medicaid coverage is provided in accordance with 8.200.400.14 NMAC.

[8.294.600.10 NMAC - Rp, 8.294.600.10 NMAC, 1/1/2019; A, 4/5/2022]

 

8.294.600.11 REPORTING REQUIREMENTS: All changes that may affect eligibility must be reported within 10 calendar days of the date of the change as detailed in 8.291.400 NMAC.

[8.292.600.11 NMAC - Rp, 8.294.600.11 NMAC, 1/1/2019]

 

 

HISTORY OF 8.294.600 NMAC:

 

History of Repealed Material:

8.294.600 NMAC, Benefit Description, filed 9/17/2013 - Duration expired 12/31/2013.

8.294.600 NMAC, Benefit Description, filed 12/17/2013 Repealed effective 1/1/2019.