TITLE 8              SOCIAL SERVICES

CHAPTER 300  MEDICAID GENERAL INFORMATION

PART 6                RESPONSIBILITY AND DELEGATION OF AUTHORITY

 

8.300.6.1              ISSUING AGENCY:  New Mexico Health Care Authority.

[8.300.6.1 NMAC - Rp 8.300.6.1 NMAC, 7/1/2024]

 

8.300.6.2              SCOPE:  The rule applies to the general public.

[8.300.6.2 NMAC - Rp 8.300.6.2 NMAC, 7/1/2024]

 

8.300.6.3              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 27-2-12 et seq. NMSA 1978 (Repl. Pamp. 2007).  Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as a single, unified department to administer laws and exercise functions relating to health care facility licensure and health care purchasing and regulation.

[8.300.6.3 NMAC - Rp 8.300.6.3 NMAC, 7/1/2024]

 

8.300.6.4              DURATION:  Permanent.

[8.300.6.4 NMAC - Rp 8.300.6.4 NMAC, 7/1/2024]

 

8.300.6.5              EFFECTIVE DATE:  July 1, 2024, unless a later date is cited at the end of a section.

[8.300.6.5 NMAC - Rp 8.300.6.5 NMAC, 7/1/2024]

 

8.300.6.6              OBJECTIVE:  The objective of these rules is to provide instruction for the service portion of the New Mexico medical assistance programs.

[8.300.6.6 NMAC - Rp 8.300.6.6 NMAC, 7/1/2024]

 

8.300.6.7              DEFINITIONS:  [RESERVED]

 

8.300.6.8              MISSION STATEMENT:  The mission of the New Mexico medical assistance division (MAD) is to maximize the health status of eligible recipients by furnishing payment for quality health services at levels comparable to private health plans.

[8.300.6.8 NMAC - Rp 8.300.6.8 NMAC, 7/1/2024]

 

8.300.6.9              RESPONSIBILITY AND DELEGATION OF AUTHORITY TO DIVISION:  MAD administers the state medicaid program and other health care programs.  MAD pays for medically necessary services furnished to eligible recipients who qualify for public assistance programs, institutional care programs, and optional programs under federal Social Security Act and other designated programs.  See 27-2-12 et seq. NMSA 1978 (Repl. Pamp. 2007).  Coverage of services by medicaid is based on the federal Social Security Act, as amended, and subject to the appropriations and availability of federal and state funds.  Administration may be provided through designated contractors and other state agencies.

[8.300.6.9 NMAC - Rp 8.300.6.9 NMAC, 7/1/2024]

 

8.300.6.10            STATUS OF PROVIDER TO HEALTH CARE AUTHORITY:  A provider, its agents and employees are independent contractors who perform professional services for eligible recipients served through health care programs administered by HCA or its authorized agents and are not employees of HCA, or the state of New Mexico.  A provider shall not purport to bind either HCA or the state of New Mexico to any obligation not expressly authorized, unless HCA has given the provider express written permission to do so.

[8.300.6.10 NMAC - Rp 8.300.6.10 NMAC, 7/1/2024]

 

HISTORY OF 8.300.6 NMAC:

Pre-NMAC History:  The material in this part was derived from that previously filed with the State Records Center:

SP-001.0400, Section 1, Single State Agency Organization State Medical Care Advisory Committee, filed 1/15/1981.

SP-004.0700, Section 4, General Program Administration Maintenance of Reports, filed 1/23/1981.

SP-001.0203, Section 1, Single State Agency Organization Professional Medical Personnel and Supporting Staff, filed 3/3/1981.

SP-004.0900, Section 4, General Program Administration Reporting Provider Payments to Internal Revenue Service, filed 3/3/1981.

SP-001.0202, Section 1, Single State Agency Organization and Function of Medical Assistance Unit, filed 3/11/1981.

 

History of Repealed Material:

8 NMAC 4.MAD.020, Responsibility and Delegation of Authority, filed 1/18/1995 - Repealed effective 4/15/2009.

8.300.6 NMAC - Responsibility And Delegation Of Authority (filed 3/25/2009) Repealed effective 7/1/2024.

 

Other:  8.300.6 NMAC - Responsibility And Delegation Of Authority (filed 3/25/2009) Replaced by 8.300.6 NMAC - Responsibility And Delegation Of Authority (filed 3/25/2009) Replaced by 8.300.6 NMAC - Responsibility And Delegation Of Authority effective 7/1/2024.