N.M. Admin. Code § 8.281.600.12

Current through Register Vol. 35, No. 20, October 22, 2024

Section 8.281.600.12 - ONGOING BENEFITS

A complete redetermination of eligibility must be performed by the ISD worker for each open case at least annually.

A.Regular reviews: For each regular yearly review, the ISD worker must determine:

(1) whether medical care credit payments are up to date; an overdue balance may indicate a change in circumstances that is unreported, particularly where rental property is involved; and

(2) whether the deposit to the recipient's personal fund is consistently no more than the applicable personal needs allowance amount per month; a larger deposit may indicate an increase in income that is unreported or a previously unidentified source of income.

B. Level of care reviews are required to be completed at least annually. Level of care determinations are made by the utilization review contractor or a member's selected or assigned managed care organization.

N.M. Admin. Code § 8.281.600.12

8.281.600.12 NMAC - Rp, 8 NMAC 4.ICM.624, 4/1/09, Adopted by New Mexico Register, Volume XXIX, Issue 24, December 27, 2018, eff. 1/1/2019