N.M. Admin. Code § 8.102.501.9

Current through Register Vol. 36, No. 1, January 14, 2025

Section 8.102.501.9 - CONTINUED ELIGIBILITY

A. Six month reporting requirement: All benefit groups participating in the TBP shall be assigned to a six month reporting requirement. A benefit group assigned to a six month reporting shall be required to file a six month report no later than the 10 day of the sixth month or in conjunction with the interim report or SNAP recertification, whichever is appropriate. The benefit group must include the following information along with verification:

(1) any change in benefit group composition, whether a member has moved in or out of the home along with the date, the change took place;

(2) the amount of money received from employment by each benefit group member;

(3) the amount of unearned income received by each benefit group member;

(4) verification for residence, only if, there has been a change in residence since the last certification;

(5) changes in child support receipt; and

(6) changes in alien status for a benefit group member.

B. Continued eligibility at the six month reporting: For continued TBP eligibility, the benefit group must meet all of the following criteria:

(1) engaged in paid unsubsidized employment for at least 30 hours per week, averaged over a month;

(2) have earnings from paid unsubsidized employment that do not exceed one-hundred fifty percent of the federal poverty guidelines; and

(3) have not reached the benefit group's 18 month TBP lifetime limit or 60-month lifetime limit as an adult, minor head of household or spouse of a minor head of household.

C. Action on changes reported between reporting periods for benefit groups assigned to six month reporting:

(1) The HCA shall not act on reported changes between reporting periods that would result in a decrease in benefits with the following exceptions:

(a) a benefit group reports income in excess of one-hundred fifty percent of federal poverty guidelines for size of the benefit group;

(b) a benefit group report loss of paid unsubsidized employment;

(c) a benefit group reports, or the HCA receives documented evidence that the benefit group has moved from the state or intends to move from the state on a specific date;

(d) a benefit group requests closure;

(e) the HCA receives documented evidence that the head the of benefit group has died; or

(f) at the time of a mass change.

(2) A newborn shall be added to the benefit group effective the month following the month the report is received, if the addition is reported to the agency by the benefit group or by the hospital for medicaid purposes.

D. Notice: An eligible benefit group that qualifies and is eligible for the bonus shall be issued notice in accordance with policy at 8.102.110.13 NMAC and for the following circumstances:

(1) Approval: An approval notice shall be issued at the time the benefit group is determined eligible. The approval notice shall identify the amount of approval and recertification date.

(2) Benefit change: A benefit group shall be issued a notice at the time the benefit group is increased or decreased. The amount of benefit is subject to change due to the availability of state or federal funds.

(3) Ineligibility: A benefit group shall be issued a notice when the benefit group no longer qualifies or is not eligible for the TBP due to a reportable change or at time of interim reporting.

N.M. Admin. Code § 8.102.501.9

8.102.501.9 NMAC - N, 7/1/2008; A, 8/14/2009, Amended by New Mexico Register, Volume XXXIV, Issue 11, June 13, 2023, eff. 7/1/2023, Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024