N.M. Admin. Code § 8.231.600.10

Current through Register Vol. 35, No. 24, December 23, 2024

Section 8.231.600.10 - BENEFIT DETERMINATION

A. Medical service providers must give the name and case number of the New Mexico medicaid eligible mother and the name, birth date, sex of the newborn, and the name of the hospital where the birth occurred to local county income support division (ISD) office. Within three days after receipt of this information, the income support specialist (ISS):

(1) determines if the mother was eligible for New Mexico medicaid at the time of birth or if the birth and delivery was covered by emergency medical services to undocumented non-citizens (EMSNC);

(2) registers the newborn for medicaid on the system; a signed application is not required;

(3) provides eligibility information to the hospital; and

(4) notifies the mother that a signed application is necessary to establish the newborn's eligibility for temporary assistance for needy families (TANF), if applicable.

B.Processing time limit: All applications must be processed within 45 days from the date of application. The time limit begins on the day the signed application is received. Applications must be acted upon and notice of approval, denial or delay sent out within the required time limit. The ISS explains the time limit and that the applicant may request an administrative hearing if the application pends longer than the time limit allows.

N.M. Admin. Code § 8.231.600.10

8.231.600.10 NMAC - Rp, 8.231.600.10 NMAC, 1-1-14, Adopted by New Mexico Register, Volume XXVIII, Issue 18, September 26, 2017, eff. 10/1/2017, Adopted by New Mexico Register, Volume XXIX, Issue 24, December 27, 2018, eff. 1/1/2019, Amended by New Mexico Register, Volume XXXII, Issue 24, December 28, 2021, eff. 1/1/2022