N.M. Stat. § 28-16A-16

Current through 2024, ch. 69
Section 28-16A-16 - Determination of rates for payment for support and services
A. The department shall develop, implement and maintain a provider reimbursement system based on the level of support and services required by a person with a developmental disability.
B. Beginning in 2024, contingent on available funding, the department shall conduct an independent biennial cost study for the purpose of recommending reimbursement rates for all service providers. The cost study shall include all reasonable costs of providing services. Recommended reimbursement rates, based on the cost study, shall include consideration of the following factors:
(1) the additional costs that would be incurred by the direct support provider agency if all direct support professionals were paid at least one hundred fifty percent of the state minimum wage;
(2) recent and projected changes in costs due to factors that include inflation, changes in the applicable minimum wage or newly effective requirements for employers during the period covered by the cost study; and
(3) direct support professional vacancies that affect direct support provider agency costs.
C. The department's budget request for each fiscal year shall include sufficient funding to:
(1) continue to provide supports and services for persons with developmental disabilities currently being served, based on the service provider reimbursement rates recommended by the most recent cost study; and
(2) serve additional persons, who as determined by the department, are eligible for but are not currently receiving services.
D. If sufficient funds have been appropriated to implement the reimbursement rates recommended by the most recent cost study, the department shall implement those rates, subject to approval by the federal centers for medicare and medicaid services. If the level of funding for developmental disabilities services and support is determined to be insufficient to fully implement such rates, the department shall adjust reimbursement rates as favorably as possible based on the level of funding available, subject to approval by the federal centers for medicare and medicaid services.
E. Contractors shall be required to submit records of support and services delivered as determined by the department, subject to monitoring by the department.

NMS § 28-16A-16

Laws 1993, ch. 50, § 16.
Amended by 2023, c. 160,s. 3, eff. 6/13/2023.