Section 27-2-12.6 - Medicaid payments; managed care.

NM Stat § 27-2-12.6 (2019) (N/A)

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A. The department shall provide for a statewide, managed care system to provide cost-efficient, preventive, primary and acute care for medicaid recipients by July 1, 1995.

B. The managed care system shall ensure:

(1) access to medically necessary services, particularly for medicaid recipients with chronic health problems;

(2) to the extent practicable, maintenance of the rural primary care delivery infrastructure;

(3) that the department's approach is consistent with national and state health care reform principles; and

(4) to the maximum extent possible that medicaid-eligible individuals are not identified as such except as necessary for billing purposes.

C. The department may exclude nursing homes, intermediate care facilities for the mentally retarded, medicaid in-home and community-based waiver services and residential and community-based mental health services for children with serious emotional disorders from the provisions of this section.

History: Laws 1994, ch. 62, § 22.

Cross references. — For Money Follows the Person in New Mexico Act, see 27-15-1 NMSA 1978.

Subsection B of Section 27-1-16 does not apply to New Mexico's managed health care system or managed care organizations. Starko, Inc. v. N.M. Human Servs. Dep't, 2014-NMSC-033, rev'g 2012-NMCA-053, 276 P.3d 252.

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Section 27-2-12.7 - Medicaid; human services department employees; standards of conduct; enforcement.