46th legislature - STATE OF NEW MEXICO - first session, 2003

RELATING TO MEDICAID; PROVIDING A PROCEDURE FOR SETTING CERTAIN MEDICAID REIMBURSEMENT RATES; EXPANDING THE ELIGIBILITY CRITERIA FOR 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] MEDICAID PAYMENT RATES FOR PHYSICIANS.--

A. For fiscal year 2004, the department shall provide reimbursement for physicians participating in the medicaid program in an amount equal to one hundred twenty-five percent of the medicare reimbursement rate. The reimbursement rate shall be based on the service provided or procedure performed as identified in the federal health care financing administration's common procedure coding system.

B. On July 1, 2004 and on July 1 of each subsequent year, the department shall increase the reimbursement rates established pursuant to Subsection A of this section. The annual percentage increase shall not be less than the percentage increase provided by the department in the previous fiscal year for managed care organizations in the medicaid managed care system."

Section 2. Section 27-2B-15 NMSA 1978 (being Laws 1998, Chapter 8, Section 15 and Laws 1998, Chapter 9, Section 15, as amended by Laws 2001, Chapter 295, Section 8 and by Laws 2001, Chapter 326, Section 8) is amended to read:

"27-2B-15. MEDICAID ELIGIBILITY.--

A. The following are eligible for medicaid:

(1) a participant who is in transition to self-sufficiency due to employment or child support;

(2) a pregnant woman who meets the income and resource requirements for New Mexico's aid to families with dependent children as they existed on July 16, 1996;

(3) a member of a benefit group who is eighteen years of age or younger if the benefit group's income is below one hundred eighty-five percent of the federal poverty guidelines;

(4) a member of a benefit group if the benefit group's income is below one hundred percent of the federal poverty guidelines;

[(4)] (5) a pregnant woman whose income is below one hundred eighty-five percent of the federal poverty guidelines;

[(5) participants] (6) a participant receiving federal supplemental security income;

[(6)] (7) an aged, blind or disabled person in an institution who meets all the supplemental security income standards except for income;

[(7)] (8) a person who meets all standards for institutional care but is cared for at home and meets eligibility standards for medicaid;

[(8)] (9) a qualified medicare beneficiary, qualified disabled working person or specified low-income medicare beneficiary; and

[(9)] (10) a foster child in the custody of the state or of an Indian pueblo, tribe or nation who meets eligibility standards for medicare.

B. Effective October 1, 2001, for the medicaid

category designated "JUL medicaid" by the department, the

income eligibility criteria shall be the same as the income

eligibility criteria set forth in the New Mexico Works Act."

Section 3. EFFECTIVE DATE.--The effective date of the provisions of this act is July 1, 2003.