0001| HOUSE BILL 208 | 0002| 43RD LEGISLATURE - STATE OF NEW MEXICO - SECOND SESSION, 1998 | 0003| INTRODUCED BY | 0004| LUCIANO "LUCKY" VARELA | 0005| | 0006| | 0007| FOR THE LEGISLATIVE FINANCE COMMITTEE AND | 0008| THE HEALTH AND WELFARE REFORM COMMITTEE | 0009| | 0010| AN ACT | 0011| RELATING TO HEALTH; ENACTING THE CHILD HEALTH ACT; CREATING | 0012| THE HEALTHY KIDS PROGRAM; AMENDING, REPEALING AND ENACTING | 0013| SECTIONS OF THE NMSA 1978; MAKING AN APPROPRIATION; DECLARING | 0014| AN EMERGENCY. | 0015| | 0016| BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO: | 0017| Section 1. [|NEW MATERIAL|] SHORT TITLE.--Sections 1 | 0018| through 7 of this act may be cited as the "Child Health Act". | 0019| Section 2. [|NEW MATERIAL|] DEFINITIONS.--As used in the | 0020| Child Health Act: | 0021| A. "child" means a natural person who has not | 0022| reached his nineteenth birthday; | 0023| B. "department" means the human services | 0024| department; | 0025| C. "low-income family" means a family with income | - 1 - 0001| at or below the level specified in Section 5 of the Child | 0002| Health Act; and | 0003| D. "secretary" means the secretary of human | 0004| services. | 0005| Section 3. [|NEW MATERIAL|] HEALTHY KIDS PROGRAM | 0006| CREATED.--After consultation with the secretary of health and | 0007| the secretary of children, youth and families, the secretary is | 0008| directed to design and implement a program to provide health | 0009| services to children and adults in low-income families in | 0010| accordance with the provisions of the Child Health Act. The | 0011| program shall be known as "healthy kids". It|| shall meet the | 0012| requirements for obtaining allotted federal funds pursuant to | 0013| the provisions of Title 21 of the federal Social Security Act. | 0014| In accordance with those requirements and the requirements of | 0015| the Child Health Act, the secretary shall prepare and submit a | 0016| child health plan to the secretary of health and human | 0017| services. Healthy kids shall be administered by the | 0018| department. | 0019| Section 4. [|NEW MATERIAL|] PROGRAM OBJECTIVES-- | 0020| DEVELOPMENT OF PLAN AND ADOPTION OF RULES.-- | 0021| A. The child health plan and healthy kids shall be | 0022| designed to achieve the following objectives: | 0023| (1) expand access to and coverage for full or | 0024| partial payment for a comprehensive array of personal health | 0025| services for children and adults in low-income families that do | - 2 - 0001| not have those services at present; | 0002| (2) increase measurably the quality of life | 0003| and well-being for the state's citizens by ensuring the good | 0004| health of children and adults in low-income families; | 0005| (3) reduce substantially the occurrence rates | 0006| of preventable illness and disease, morbidity and mortality in | 0007| the state's population; | 0008| (4) increase positively the benefit-to-cost | 0009| ratios of health services provided in the state to the | 0010| population as a whole while at the same time improving the | 0011| quality of service when measured by both scientifically | 0012| objective and beneficiary-perceived criteria; | 0013| (5) retard escalation of health care costs in | 0014| all segments of the health care industry; and | 0015| (6) provide through experimentation and | 0016| demonstration projects, coupled with any necessary and | 0017| appropriate federal waivers of conditions for expenditure | 0018| approval, innovative and imaginative methods of providing | 0019| health care to all segments of the state's population. | 0020| B. Implementation of an approved child health plan | 0021| shall be in accordance with rules adopted by the secretary. | 0022| The rules shall be designed to achieve and be consistent with | 0023| the objectives specified in Subsection A of this section. | 0024| Those objectives are stated as mandatory standards by which the | 0025| validity of proposed rules shall be tested. Additionally, the | - 3 - 0001| rules must be consistent with those provisions of the Child | 0002| Health Act that mandate program requirements. | 0003| Section 5. [|NEW MATERIAL|] PLAN CONTENT--REQUIRED | 0004| ELEMENTS.--The child health plan and the program of services to | 0005| be provided by it shall include: | 0006| A. a one-year period measured from the date of | 0007| federal approval of the child health plan to be known as "phase | 0008| one", during which the following shall occur: | 0009| (1) the family income eligibility requirement | 0010| for participation of children in healthy kids shall be | 0011| established at two hundred thirty-five percent of the federal | 0012| poverty level; | 0013| (2) presumptive eligibility procedures shall | 0014| be established and initiated; | 0015| (3) a simplified application process shall be | 0016| established and implemented; | 0017| (4) the locations of eligibility workers shall | 0018| be diversified; | 0019| (5) training for health care providers to | 0020| enable them to assist families in filling out application forms | 0021| shall be developed and implemented; and | 0022| (6) specific outreach procedures shall be | 0023| developed, including within those procedures ways to recognize | 0024| and accommodate cultural diversity, to involve families of | 0025| children likely to be eligible for healthy kids or other public | - 4 - 0001| or private health coverage programs and to inform these | 0002| families of the availability of and assist them in enrolling in | 0003| those programs; | 0004| B. a two-year period measured from the date of | 0005| federal approval of the child health plan to be known as "phase | 0006| two", during which the following shall occur: | 0007| (1) a continuum of prevention and intervention | 0008| services shall be developed and implemented consisting of at | 0009| least the following, including applications for any federal | 0010| waivers of conditions that are necessary: | 0011| (a) implementation of a universal home | 0012| visiting program for mothers having their first child, | 0013| beginning during pregnancy and extending for two years, with a | 0014| frequency of use as both desired and medically indicated; | 0015| (b) creation of a program of early | 0016| intervention developmental services; | 0017| (c) provision of a behavioral health | 0018| identification, assessment and management system; | 0019| (d) expansion of school-based health | 0020| services into the network of health care programs; | 0021| (e) expansion of the healthier kids fund | 0022| administered by the department of health to enable children to | 0023| have effective access to health care; and | 0024| (f) development of ways to increase | 0025| children's dental services; and | - 5 - 0001| (2) development of a plan to provide health | 0002| services to uninsured parents of children eligible for healthy | 0003| kids; | 0004| C. twelve months of continuous coverage for healthy | 0005| kids beneficiaries; | 0006| D. a requirement that no asset test be imposed as a | 0007| condition of eligibility for children; | 0008| E. provisions for inhibiting or preventing both | 0009| employer crowd-out and employee crowd-out; | 0010| F. requirements that in its development and | 0011| implementation interests of Native American children are | 0012| identified and that appropriate provisions for their enrollment | 0013| are made with recognition that the application process and the | 0014| delivery of services with respect to those children present | 0015| special cultural and other considerations; | 0016| G. provisions for the coordination of the | 0017| administration of healthy kids with other public and private | 0018| health programs; | 0019| H. identification and implementation of methods, | 0020| including monitoring, used to ensure the quality and | 0021| appropriateness of care, particularly with respect to well-baby | 0022| care, well-child care and immunizations provided under the plan | 0023| and to ensure access to covered services, including emergency | 0024| services; | 0025| I. methods by which the state will collect data, | - 6 - 0001| maintain the records and furnish required reports to the | 0002| secretary of health and human services; and | 0003| J. specific requirements for and description of the | 0004| means to be used to ensure that members of the public will be | 0005| involved in the design and implementation of the plan and a | 0006| description of a method to ensure ongoing public involvement. | 0007| Section 6. [|NEW MATERIAL|] CREATION OF LEGISLATIVE | 0008| OVERSIGHT COMMITTEE--AUTHORITY AND DUTIES.-- | 0009| A. There is created a joint interim legislative | 0010| committee, which shall be known as the "healthy kids oversight | 0011| committee". | 0012| B. The committee shall be composed of eight | 0013| members. Four members of the house of representatives shall be | 0014| appointed by the speaker of the house of representatives and | 0015| four members of the senate shall be appointed by the | 0016| committees' committee of the senate or, if the senate | 0017| appointments are made in the interim, by the president pro | 0018| tempore of the senate after consultation with and agreement of | 0019| a majority of the members of the committees' committee. Members | 0020| shall be appointed so that there is a member from each of the | 0021| major political parties from each house. No member who has a | 0022| financial interest in an insurance company or health care | 0023| provider shall be appointed to the committee. | 0024| C. The healthy kids oversight committee shall | 0025| oversee the development and operations of healthy kids created | - 7 - 0001| pursuant to the Child Health Act. It shall fulfill any | 0002| responsibilities delegated to it pursuant to that act. | 0003| D. The committee shall report annually its findings | 0004| and recommendations regarding healthy kids to each regular | 0005| session of the legislature and shall include in that report any | 0006| recommendations for changes in the laws pertaining to the | 0007| program. | 0008| Section 7. [|NEW MATERIAL|] CREATION OF HEALTHY KIDS FUND.- | 0009| - | 0010| The "healthy kids fund" is created in the state treasury. | 0011| Revenue consisting of all amounts shall be deposited in the fund. | 0012| Interest earned by investment of the fund shall be deposited in | 0013| the fund. Balances of the fund shall not revert to the general | 0014| fund at the close of any fiscal year. Expenditures from the fund | 0015| shall be made pursuant to warrants drawn by the department of | 0016| finance and administration upon vouchers submitted by the | 0017| secretary of human services for the purpose of providing state | 0018| funds needed to match federal funds for payment of the costs of | 0019| healthy kids operated by the human services department pursuant | 0020| to the Child Health Act. | 0021| Section 8. Section 27-2-1 NMSA 1978 (being Laws 1973, | 0022| Chapter 376, Section 1) is amended to read: | 0023| "27-2-1. SHORT TITLE.--Sections ~[1 through 20 of this act | 0024| and Sections 13-1-9, 13-1-10, 13-1-12, 13-1-13, 13-1-17, | 0025| 13-1-18, 13-1-18.1, 13-1-19, 13-1-20, 13-1-20.1, 13-1-21, | - 8 - 0001| 13-1-22, 13-1-27, 13-1-27.2, 13-1-27.3, 13-1-27.4, 13-1-28, | 0002| 13-1-28.6, 13-1-29, 13-1-30, 13-1-34, 13-1-35, 13-1-37, 13-1-39, | 0003| 13-1-40, 13-1-41 and 13-1-42 NMSA 1953]~ |27-2-1 through 27-2-36 | 0004| NMSA 1978| may be cited as the "Public Assistance Act"." | 0005| Section 9. Section 27-2-12 NMSA 1978 (being Laws 1973, | 0006| Chapter 376, Section 16, as amended) is amended to read: | 0007| "27-2-12. MEDICAL ASSISTANCE ~[PROGRAMS]~ |PROGRAM-- | 0008| MEDICAID|.--Consistent with the federal act and subject to the | 0009| appropriation and availability of federal and state funds, the | 0010| medical assistance division of the human services department may | 0011| by ~[regulation]~ |rule| provide medical assistance ~[including | 0012| the services of licensed doctors of oriental medicine and | 0013| licensed chiropractors, to persons eligible for public assistance | 0014| programs under the federal act]~ |pursuant to a state plan | 0015| approved by the federal health and human services department in | 0016| accordance with Title 19 of the federal act. This medical | 0017| assistance program shall be known as "medicaid"|." | 0018| Section 10. Section 27-2-12.2 NMSA 1978 (being Laws 1987, | 0019| Chapter 16, Section 1, as amended) is amended to read: | 0020| "27-2-12.2. ~[MEDICAL ASSISTANCE PROGRAM]~ |MEDICAID|-- | 0021| ELIGIBILITY OF MARRIED INDIVIDUALS.--For the purpose of | 0022| determining ~[medical assistance]~ |medicaid eligibility| for | 0023| |the| institutional care program ~[eligibility under the Public | 0024| Assistance Act]~, the community spouse resource allowance for a | 0025| community spouse as defined and authorized by the federal | - 9 - 0001| Medicare Catastrophic Coverage Act of 1988 shall be a minimum of | 0002| thirty thousand dollars ($30,000)." | 0003| Section 11. Section 27-2-12.3 NMSA 1978 (being Laws 1987, | 0004| Chapter 269, Section 1, as amended) is amended to read: | 0005| "27-2-12.3. MEDICAID REIMBURSEMENT--EQUAL PAY FOR EQUAL | 0006| PHYSICIANS', DENTISTS', OPTOMETRISTS', PODIATRISTS' AND | 0007| PSYCHOLOGISTS' SERVICES.--The ~[human services]~ department shall | 0008| establish a rate for the reimbursement of physicians, dentists, | 0009| optometrists, podiatrists and psychologists for services rendered | 0010| to medicaid patients that provides equal reimbursement for the | 0011| same or similar services rendered without respect to the date on | 0012| which such physician, dentist, optometrist, podiatrist or | 0013| psychologist entered into practice in New Mexico; the date on | 0014| which the physician, dentist, optometrist, podiatrist or | 0015| psychologist entered into an agreement or contract to provide | 0016| such services; or the location in which such services are to be | 0017| provided in the state; provided, however, that the requirements | 0018| of this section shall not apply when the ~[human services]~ | 0019| department contracts with entities pursuant to Section 27-2-12.6 | 0020| NMSA 1978 to negotiate a rate for the reimbursement for services | 0021| rendered to medicaid patients in the medicaid managed care | 0022| system." | 0023| Section 12. Section 27-2-12.4 NMSA 1978 (being Laws 1987, | 0024| Chapter 214, Section 1) is amended to read: | 0025| "27-2-12.4. LONG-TERM CARE FACILITIES--NONCOMPLIANCE WITH | - 10 - 0001| STANDARDS AND CONDITIONS--SANCTIONS.-- | 0002| A. In addition to any other actions required or | 0003| permitted by federal law or regulation, the ~[human services]~ | 0004| department shall impose a hold on ~[state]~ medicaid payments to | 0005| a long-term care facility thirty days after the |department of| | 0006| health ~[and environment department]~ notifies the ~[human | 0007| services]~ department in writing pursuant to an on-site visit | 0008| that the long-term care facility is not in substantial compliance | 0009| with the standards or conditions of participation promulgated by | 0010| the federal department of health and human services pursuant to | 0011| which the facility is a party to a medicaid provider agreement, | 0012| unless the substantial noncompliance has been corrected within | 0013| that thirty-day period or the facility's medicaid provider | 0014| agreement is terminated or not renewed based in whole or in part | 0015| on the noncompliance. The written notice shall cite the specific | 0016| deficiencies that constitute noncompliance. | 0017| B. The ~[human services]~ department shall remove the | 0018| payment hold imposed under Subsection A of this section when the | 0019| |department of| health ~[and environment department]~, pursuant | 0020| to an on-site visit, certifies in writing to the ~[human | 0021| services]~ department that the long-term care facility is in | 0022| substantial compliance with the standards or conditions of | 0023| participation pursuant to which the facility is a party to a | 0024| medicaid provider agreement. | 0025| C. The ~[human services]~ department shall not | - 11 - 0001| reimburse any long-term care facility during the payment hold | 0002| period imposed pursuant to Subsection A of this section for any | 0003| medicaid ~[recipient-patients]~ |patients| who are new admissions | 0004| and who are admitted on or after the day the hold is imposed and | 0005| prior to the day the hold is removed. | 0006| D. If a long-term care facility is certified in | 0007| writing to be in noncompliance pursuant to Subsection A of this | 0008| section for the second time in any twelve-month period, the | 0009| ~[human services]~ department shall cancel or refuse to execute | 0010| the long-term care facility's medicaid provider agreement for a | 0011| two-month period, unless it can be demonstrated that harm to the | 0012| patients would result from this action or that good cause exists | 0013| to allow the facility to continue to participate in ~[the]~ | 0014| medicaid ~[program]~. The provisions of this subsection are | 0015| subject to appeal procedures set forth in federal regulations for | 0016| nonrenewal or termination of a medicaid provider agreement. | 0017| E. A long-term care facility shall not charge | 0018| medicaid ~[recipient-patients]~ |beneficiaries|, their families | 0019| or their responsible parties to recoup ~[any]~ payments not | 0020| received because of a hold on medicaid payments imposed pursuant | 0021| to this section. | 0022| F. This section ~[shall not be construed to]~ |does | 0023| not| affect any other provisions for medicaid provider agreement | 0024| termination, nonrenewal, due process and appeal pursuant to | 0025| federal law or regulation. | - 12 - 0001| G. As used in this section: | 0002| (1) "day" means a twenty-four hour period | 0003| beginning at midnight and ending one second before midnight; | 0004| (2) "long-term care facility" means any | 0005| intermediate care facility or skilled nursing facility ~[which]~ | 0006| |that| is licensed by the |department of| health ~[and | 0007| environment department]~ and ~[which]~ is medicaid certified; | 0008| (3) "new admissions" means medicaid | 0009| ~[recipients]~ |patients| who have never been in the long-term | 0010| care facility or, if previously admitted, had been discharged or | 0011| had voluntarily left the facility, but the term does not include: | 0012| (a) individuals who were in the long-term | 0013| care facility before the effective date of the hold on medicaid | 0014| payments and became eligible for medicaid after that date; and | 0015| (b) individuals who, after a temporary | 0016| absence from the facility, are readmitted to beds reserved for | 0017| them in accordance with federal regulations; and | 0018| (4) "substantial compliance" means the condition | 0019| of having no cited deficiencies or having only those cited | 0020| deficiencies ~[which]~ |that|: | 0021| (a) are not inconsistent with any federal | 0022| statutory requirement; | 0023| (b) do not interfere with adequate patient | 0024| care; | 0025| (c) do not represent a hazard to the | - 13 - 0001| patients' health or safety; | 0002| (d) are capable of correction within a | 0003| reasonable period of time; and | 0004| (e) are ~[ones which]~ |deficiencies| the | 0005| long-term care facility is making reasonable plans to correct." | 0006| Section 13. Section 27-2-12.5 NMSA 1978 (being Laws 1989, | 0007| Chapter 83, Section 1, as amended) is amended to read: | 0008| "27-2-12.5. MEDICAID-CERTIFIED NURSING FACILITIES-- | 0009| RETROACTIVE ELIGIBILITY--REFUNDS--PENALTY.-- | 0010| A. Medicaid payment for a medicaid-eligible patient | 0011| shall be accepted by a medicaid-certified nursing facility from | 0012| the first month of medicaid eligibility, regardless of whether | 0013| the eligibility is retroactive. The nursing facility shall | 0014| refund to the patient or responsible party all out-of-pocket | 0015| money except for required medical-care credits paid to the | 0016| nursing facility for that patient's care on and after the date of | 0017| medicaid eligibility for services covered by the medicaid | 0018| program. Within thirty days after notification by the ~[human | 0019| services]~ department of the patient's medicaid eligibility, the | 0020| nursing facility shall make any necessary refund to the patient | 0021| or responsible party required under this section. | 0022| B. In any ~[cause of action]~ |lawsuit| brought | 0023| against a nursing facility because of its failure to make a | 0024| refund to the patient or responsible party as required under | 0025| Subsection A of this section, the patient or responsible party | - 14 - 0001| may be awarded |damages equal to| triple the amount of the money | 0002| not refunded or three hundred dollars ($300), whichever is | 0003| greater, ~[and]~ reasonable ~[attorneys']~ |attorney| fees and | 0004| ~[court]~ costs." | 0005| Section 14. Section 27-2-12.6 NMSA 1978 (being Laws 1994, | 0006| Chapter 62, Section 22) is amended to read: | 0007| "27-2-12.6. MEDICAID PAYMENTS--MANAGED CARE.-- | 0008| A. The department shall provide for a statewide | 0009| managed care system to provide cost-efficient, preventive, | 0010| primary and acute |health| care for medicaid ~[recipients by July | 0011| 1, 1995]~ |beneficiaries|. | 0012| B. The managed care system shall ensure: | 0013| (1) access to medically necessary services, | 0014| particularly for medicaid ~[recipients]~ |beneficiaries| with | 0015| chronic health problems; | 0016| (2) to the extent practicable, maintenance of | 0017| the rural primary care delivery infrastructure; | 0018| (3) that the department's approach is consistent | 0019| with national and state health care reform principles; and | 0020| (4) to the maximum extent possible, that | 0021| ~[medicaid-eligible individuals]~ |beneficiaries| are not | 0022| identified as such except as necessary for billing purposes. | 0023| C. The department may exclude nursing homes, | 0024| intermediate care facilities for the mentally retarded, medicaid | 0025| in-home and community-based waiver services and residential and | - 15 - 0001| community-based mental health services for children with serious | 0002| emotional disorders from the provisions of this section." | 0003| Section 15. Section 27-2-12.7 NMSA 1978 (being Laws 1980, | 0004| Chapter 86, Section 1) is amended to read: | 0005| "27-2-12.7. MEDICAID--HUMAN SERVICES DEPARTMENT EMPLOYEES-- | 0006| STANDARDS OF CONDUCT--ENFORCEMENT.-- | 0007| A. As used in this section: | 0008| (1) "business" means a corporation, partnership, | 0009| sole proprietorship, firm, organization or individual carrying on | 0010| a business; | 0011| ~[(2) "department" means the human services | 0012| department; | 0013| (3)]~ |(2)| "employee" means ~[any]~ |a| person | 0014| who has been appointed to or hired for ~[any]~ |a| department | 0015| office connected with the administration of medicaid funds and | 0016| who receives compensation in the form of salary; | 0017| ~[(4)]~ |(3)| "employee with responsibility" | 0018| means an employee who is directly involved in or has a | 0019| significant part in the medicaid decision-making, regulatory, | 0020| procurement or contracting process; and | 0021| ~[(5)]~ |(4)| "financial interest" means an | 0022| interest held by an individual, his spouse or minor child | 0023| ~[which]~ |that| is: | 0024| (a) an ownership interest in business; or | 0025| (b) ~[any]~ |an| employment or prospective | - 16 - 0001| employment for which negotiations have already begun. | 0002| B. No employee with responsibility shall, for twenty- | 0003| four months following the date on which he ceases to be an | 0004| employee, act as agent or attorney for ~[any other]~ |another| | 0005| person or business in connection with a judicial or | 0006| administrative proceeding, application, ruling, contract, claim | 0007| or other matter relating to the medicaid program with respect to | 0008| which the employee made an investigation, rendered ~[any]~ |a| | 0009| ruling or was otherwise substantially and directly involved | 0010| during the last year he was an employee and ~[which]~ |that| was | 0011| actually pending under his responsibility within that period. | 0012| C. No ~[department]~ secretary |of human services|, | 0013| income support division director or medical assistance bureau | 0014| chief or their deputies shall, for twelve months following the | 0015| date on which he ceases to be an employee, participate ~[in any | 0016| manner]~ with respect to a judicial or administrative proceeding, | 0017| application, ruling, contract, claim or other matter relating to | 0018| the medicaid program and pending before the department. | 0019| D. No employee with responsibility shall participate | 0020| ~[in any manner]~ with respect to a judicial or administrative | 0021| proceeding, application, ruling, contract, claim or other matter | 0022| relating to the medicaid program and involving his spouse, minor | 0023| child or ~[any]~ |a| business in which he has a financial | 0024| interest unless prior to ~[such]~ |the| participation: | 0025| (1) full disclosure of his relationship or | - 17 - 0001| financial interest is made in writing to the secretary of ~[the | 0002| department]~ |human services|; and | 0003| (2) a written determination is made by the | 0004| secretary |of human services| that the disclosed relationship or | 0005| financial interest is too remote or inconsequential to affect the | 0006| integrity of the services of the employee. | 0007| E. Violation of any of the provisions of this section | 0008| by an employee is grounds for dismissal, demotion or suspension. | 0009| A former employee who violates ~[any of the provisions]~ |a | 0010| provision| of this section ~[shall be]~ |is| subject to | 0011| assessment by the department of a civil money penalty of two | 0012| hundred fifty dollars ($250) for each violation. The department | 0013| shall promulgate ~[regulations]~ |rules| to provide for an | 0014| administrative appeal of any assessment imposed." | 0015| Section 16. Section 27-2-12.8 (being Laws 1997, Chapter | 0016| 264, Section 1) is amended to read: | 0017| "27-2-12.8 MAMMOGRAMS FOR MEDICAID ~[RECIPIENTS]~ | 0018| |BENEFICIARIES|.--In providing coverage for mammograms under the | 0019| medicaid program, the department shall ensure that: | 0020| A. patients will not be routinely solicited for | 0021| mammograms and that mammograms will only be performed based on | 0022| nationally recognized standards; and | 0023| B. any fee for service payment that ~[shall be]~ |is| | 0024| made on behalf of ~[the]~ medicaid ~[program]~ for a mammogram of | 0025| a medicaid ~[recipient]~ |beneficiary| shall be consistent with | - 18 - 0001| and not exceed the usual and customary charge that reflects the | 0002| reasonable fair market value of the cost of a mammogram." | 0003| Section 17. Section 27-2-13 NMSA 1978 (being Laws 1973, | 0004| Chapter 376, Section 17) is amended to read: | 0005| "27-2-13. CONFLICT IN FEDERAL AND STATE LAWS.--Any section | 0006| of the NMSA ~[1953]~ |1978| ~[relating to]~ |authorizing| public | 0007| assistance ~[which]~ |that| is in conflict with the provisions of | 0008| the federal act, ~[or]~ the federal Food Stamp Act, ~[as may be | 0009| amended from time to time, and]~ |or| federal regulations issued | 0010| pursuant ~[thereto]~ |to those acts| shall be suspended in its | 0011| operation if the attorney general certifies that ~[such]~ |the| | 0012| conflict exists." | 0013| Section 18. Section 27-2-15 NMSA 1978 (being Laws 1937, | 0014| Chapter 18, Section 9) is amended to read: | 0015| "27-2-15. COOPERATION WITH THE UNITED STATES.-- | 0016| |A.| The ~[State]~ department is ~[hereby]~ | 0017| designated as the state agency to cooperate with the federal | 0018| government in the administration of the provisions of ~[Title 1, | 0019| Title 4, part 2 and 3 of Title 5 and Title 10]~ |Titles 4 and 19| | 0020| of the federal ~[Social Security Act. The State Board is hereby | 0021| authorized and directed to cooperate with the proper departments | 0022| of the federal government and with all other departments of the | 0023| state and local governments in the enforcement and administration | 0024| of such provisions of the federal Social Security Act, and any | 0025| amendments thereto and the rules and regulations issued | - 19 - 0001| thereunder, and in compliance therewith in the manner prescribed | 0002| in this act or as otherwise provided by law]~ |act|. | 0003| |B.| The department shall ~[also]~ make reports in | 0004| ~[such]~ |the| form and containing ~[such]~ |the| information | 0005| ~[as any]~ |required by an| agency or instrumentality of the | 0006| United States with which it is cooperating ~[may from time to | 0007| time require]~, and shall comply with ~[such]~ |those| provisions | 0008| ~[as any such]~ |a federal| agency or instrumentality may ~[from | 0009| time to time]~ find necessary to assure the correctness and | 0010| verification of ~[such]~ |the| reports." | 0011| Section 19. Section 27-2-17 NMSA 1978 (being Laws 1937, | 0012| Chapter 18, Section 10) is amended to read: | 0013| "27-2-17. CUSTODIAN OF FUNDS.--The ~[State]~ department is | 0014| ~[hereby]~ designated as the custodian, subject to the provisions | 0015| of Section ~[21 of this Act]~ |27-2-33 NMSA 1978|, of ~[any and]~ | 0016| all ~[monies which may be]~ |money| received by the state ~[of | 0017| New Mexico which]~ |that| the ~[State Board of Public Welfare]~ | 0018| |department| is authorized to administer |pursuant to the Public | 0019| Assistance Act|, from any appropriations made by the congress of | 0020| the United States for the purpose of cooperating with the several | 0021| states in the enforcement and administration of the provisions of | 0022| the federal ~[Social Security]~ act referred to in Section ~[9]~ | 0023| |27-2-15 NMSA 1978| and all ~[monies]~ |money| received from any | 0024| other source for ~[the]~ purposes ~[set forth in this Act]~ | 0025| |authorized by the Public Assistance Act|. The ~[State]~ | - 20 - 0001| department is ~[hereby]~ authorized to receive such ~[monies]~ | 0002| |money|, provide for ~[the]~ |its| proper custody ~[thereof]~ and | 0003| ~[to]~ make disbursements ~[therefrom]~ |of it| under such rules | 0004| ~[and regulations]~ as the ~[State Board]~ |department| may | 0005| prescribe." | 0006| Section 20. Section 27-2-23 NMSA 1978 (being Laws 1969, | 0007| Chapter 232, Section 1) is amended to read: | 0008| "27-2-23. THIRD PARTY LIABILITY |FOR MEDICAID | 0009| EXPENDITURES|.-- | 0010| A. The ~[health and social services]~ department | 0011| shall make reasonable efforts to ascertain ~[any]~ legal | 0012| liability of third parties who are or may be liable to pay all or | 0013| part of the medical cost of injury, disease or disability of an | 0014| applicant |for| or recipient of ~[medical assistance]~ | 0015| |medicaid|. | 0016| B. When the department makes ~[medical assistance]~ | 0017| |medicaid| payments ~[in behalf of a recipient]~ |for a medicaid | 0018| beneficiary|, the department is subrogated to any right of the | 0019| ~[recipient]~ |beneficiary| against a third party for recovery of | 0020| medical expenses to the extent that the department has made | 0021| payment." | 0022| Section 21. Section 27-2-23.1 NMSA 1978 (being Laws 1989, | 0023| Chapter 184, Section 1) is amended to read: | 0024| "27-2-23.1. EMPLOYEE RETIREMENT INCOME SECURITY ACT OF | 0025| 1974--EMPLOYEE HEALTH BENEFIT PLANS--CLAUSES TO EXCLUDE MEDICAID | - 21 - 0001| COVERAGE PROHIBITED.--No employee health benefit plan established | 0002| under the Employee Retirement Income Security Act of 1974, 29 | 0003| U.S.C. 1144 that provides payments for health care on behalf of | 0004| individuals residing in the state shall contain any provisions | 0005| excluding or limiting coverage or payment for any health care for | 0006| an individual who would otherwise be covered or entitled to | 0007| benefits or services under the terms of the employee health | 0008| benefit plan because that individual is provided or is eligible | 0009| for benefits ~[under the]~ |pursuant to| medicaid ~[program of | 0010| this state pursuant to Title XIX of the federal Social Security | 0011| Act, 42 U.S.C. 1396, et seq.]~." | 0012| Section 22. Section 27-2-33 NMSA 1978 (being Laws 1937, | 0013| Chapter 18, Section 21) is amended to read: | 0014| "27-2-33. METHOD OF HANDLING FUNDS.-- | 0015| |A.| All ~[monies]~ |money| received from the federal | 0016| government for carrying out ~[of]~ any of the purposes of ~[this | 0017| Act]~ |Chapter 27 NMSA 1978| and all other funds received by the | 0018| ~[State]~ department under the provisions of ~[this Act]~ |that | 0019| chapter| shall be ~[by it]~ paid ~[over]~ to the state treasurer | 0020| and ~[shall be by him]~ kept in a separate fund known as the | 0021| "social security fund" ~[and]~. All ~[monies]~ |money| in | 0022| ~[such]~ |the| fund ~[are hereby]~ |is| appropriated to the | 0023| ~[State Board]~ |department| for ~[the]~ carrying out ~[of]~ the | 0024| purposes of ~[this Act]~ |Chapter 27 NMSA 1978|, provided that | 0025| all ~[monies]~ |money| received from the federal government shall | - 22 - 0001| be spent solely for the purposes for which ~[said]~ |the| funds | 0002| were granted. | 0003| |B.| ~[By resolution of the State Board requisitions | 0004| shall be made from time to time]~ |The department shall request| | 0005| from the state treasurer ~[for]~ |the| funds needed ~[for the | 0006| carrying]~ |to carry| out ~[of any of]~ the purposes of ~[this | 0007| Act, and]~ |Chapter 27 NMSA 1978|. The funds ~[so | 0008| requisitioned]~ shall be disbursed under rules ~[and | 0009| regulations]~ of the ~[State Board provided, however, that the | 0010| State Board]~ |department, but it| shall not ~[requisition]~ | 0011| |request| at any one time ~[and]~ |or| have on hand more than | 0012| sufficient ~[monies]~ |money| to meet its estimated needs for a | 0013| period of sixty days. | 0014| |C.| The ~[State Board]~ |department| shall be | 0015| subject at all times to audit by the state ~[Comptroller|| or any | 0016| other]~ |auditor, an| agency provided by law ~[provided that an | 0017| audit by any]~ |or a| private auditor approved by the state | 0018| ~[Comptroller may be accepted by him]~ |auditor|. The ~[State | 0019| Board]~ |department| may, with the approval of the state | 0020| ~[Comptroller]~ |auditor|, provide for a continuous audit of its | 0021| transactions." | 0022| Section 23. APPROPRIATION.--Two million nine hundred | 0023| thousand dollars ($2,900,000) is appropriated from the general | 0024| fund to the healthy kids fund for expenditure by the human | 0025| services department in fiscal years 1998 and 1999 to implement | - 23 - 0001| the healthy kids program as authorized by the Child Health Act. | 0002| Any unexpended or unencumbered balance remaining in the fund at | 0003| the end of fiscal year 1999 shall revert to the general fund. | 0004| Section 24. REPEAL.--Sections 27-2-16 and 27-2-36 NMSA 1978 | 0005| (being Laws 1974, Chapter 31, Section 1 and Laws 1921, Chapter | 0006| 117, Section 9, as amended) are repealed. | 0007| Section 25. EMERGENCY.--It is necessary for the public | 0008| peace, health and safety that this act take effect immediately. | 0009|  |