HOUSE BILL 400

57th legislature - STATE OF NEW MEXICO - first session, 2025

INTRODUCED BY

Mark Duncan and Rebecca Dow and Gail Armstrong

 

 

 

 

 

AN ACT

RELATING TO MEDICAID; REQUIRING THE HEALTH CARE AUTHORITY TO CONDUCT COST STUDIES FOR EACH TYPE OF HEALTH CARE PROVIDER THAT IS REIMBURSED BY MEDICAID.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] COST STUDIES REQUIRED.--

          A. At least every three years, the authority shall conduct cost studies for the purposes of determining the cost of providing health care services for each type of health care provider that is reimbursed by medicaid for providing services to recipients. The cost studies shall include recommendations for adequate reimbursement rates for each type of health care provider reimbursed by medicaid based on:

                (1) the cost to provide competitive compensation to health care providers; and

                (2) recent and projected changes in costs due to factors that include inflation and rising wages.

          B. When the authority submits a budget request to the legislature, the authority shall include the most recent cost study performed for each type of health care provider that is reimbursed by medicaid.

          C. The authority shall not be required to perform cost studies for every type of health care provider that is reimbursed by medicaid in the same year, so long as a cost study is conducted for each type of health care provider at least every three years.

          D. For the purposes of this section, "medicaid" means the federal-state program administered by the authority pursuant to Title 19 or Title 21 of the federal Social Security Act."

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