N.M. Admin. Code § 8.308.7.11

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

Section 8.308.7.11 - MASS TRANSFER PROCESS

The mass transfer process is initiated when HSD determines that the transfer of MCO members from one MCO to another is in the best interests of the program.

A.Triggering a mass transfer: The mass transfer process may be triggered by two situations:

(1) a maintenance change, such as changes in the MCO identification number or the MCO changes its name or other changes that is not relevant to the member and services will continue with that MCO; and

(2) a significant change in a MCO's contracting status, including but not limited to, the loss of licensure, substandard care, fiscal insolvency or significant loss in network providers; in such instances, a notice is sent to the member informing him or her of the transfer and the opportunity to select a different MCO.

B.Effective date of mass transfer: The change in enrollment initiated by the mass transfer begins with the first day of the month following HSD's identification of the need to transfer MCO members.

N.M. Admin. Code § 8.308.7.11

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