N.M. Code R. § 8.308.2.15

Current through Register Vol. 35, No. 9, May 7, 2024

Section 8.308.2.15 - INDIAN HEALTH SERVICES, TRIBAL HEALTHCARE, AND URBAN INDIAN PROVIDERS (I/T/U)

A. The MCO shall make best efforts to contract with I/T/Us in the state, including, but not limited to, contracting for such services as transportation, care coordination and case management. The MCO is encouraged to use the sample I/T/U addendum as described in 42 CFR 438.14 to develop an addendum specific to New Mexico that can be used to establish network provider agreements with I/T/Us as such agreements include the federal protections for I/T/Us.

B. The MCO shall allow native American members to seek care from any I/T/U whether or not the I/T/U is a contract provider and shall reimburse I/T/Us as specified in 8.308.20 NMAC. The MCO shall permit non-contracted I/T/Us to refer native American members to a contracted provider.

C. The MCO shall not prevent members from seeking care from I/T/Us or from contract providers due to their status as native Americans.

N.M. Code R. § 8.308.2.15

8.308.2.15 NMAC - N, 1-1-14, Adopted by New Mexico Register, Volume XXIX, Issue 08, April 24, 2018, eff. 5/1/2018