New Mexico Administrative Code
Title 7 - HEALTH
Chapter 27 - EMERGENCY MEDICAL SERVICES
Part 10 - CERTIFICATION OF EMERGENCY MEDICAL SERVICES AGENCIES
Section 7.27.10.24 - ENFORCEMENT

Universal Citation: 7 NM Admin Code 7.27.10.24

Current through Register Vol. 35, No. 18, September 24, 2024

A. Complaint/incident procedures.

(1) Any person may communicate a written complaint or knowledge of an incident concerning an EMS agency or applicant to the bureau.

(2) Complaints shall be submitted in signed, written form to the bureau as soon as practical.

(3) The bureau shall notify in a timely manner an affected EMS agency or applicant that the bureau is conducting an investigation, unless extenuating circumstances reasonably preclude notification.

B. Investigations. Investigations shall be conducted by the bureau or its agent(s). The bureau shall issue to any person whom it designates as an inspector or investigator credentials to evidence the person's authority that shall bear the person's photograph. The bureau may initiate an investigation if an inspection reveals, or if the bureau otherwise becomes aware of, facts indicating a possible violation of this rule. Upon completion of the investigation, the bureau may pursue further appropriate action.

(1) Preliminary investigations. When the bureau receives information that might form the basis for disciplinary action against an EMS agency or applicant, it may begin a preliminary investigation. A preliminary investigation is a fact-finding/information-gathering investigation that will attempt to determine whether justification exists to initiate an action or to conduct a formal investigation.

(2) Formal investigations. The bureau may undertake a formal investigation for the purpose of obtaining additional information to allow the bureau to determine whether to initiate an action. The bureau shall notify the EMS agency that is the subject of the formal investigation of the pendency of that investigation, unless doing so could substantially impair the bureau's investigation, or unless other extenuating circumstances exist that would reasonably preclude notification.

(3) Confidentiality. The bureau shall take precautions to ensure that investigations are conducted in a confidential manner.

(4) Records. An official record shall be maintained for every EMS agency certified under this rule. If the bureau begins an investigation, a separate confidential record shall be created containing all investigative material. If the bureau initiates an action, all records not exempt from disclosure under the Inspection of Public Records Act, NMSA 1978, 14-2-1 et seq., shall be placed in the EMS agency's official record. Any request for records maintained by the bureau shall be processed in accordance with the Inspection of Public Records Act.

C. Waivers. The bureau, upon a showing of good cause or extenuating circumstances by an EMS agency, may waive any portion of this rule in whole or in part.

(1) An EMS agency that requests a waiver shall submit written justification to the bureau explaining what good cause or extenuating circumstances exist to grant the waiver. The EMS agency shall include any supporting documentation relevant to the request.

(2) The bureau shall determine whether to grant a requested waiver as soon as practicable. The bureau shall evaluate the request and any pertinent attached documentation. The bureau may request additional documentation in support of the EMS agency's request as the bureau deems necessary.

(3) Upon determining whether to grant or deny a waiver request, the bureau shall notify the requesting EMS agency of the bureau's decision in writing within twenty calendar days.

D. Disciplinary action; other action. The bureau may take disciplinary action against an EMS agency or applicant, including denial, suspension, or revocation of certification, or imposition of any lesser restriction or condition upon certification, in accordance with the following:

(1) if the bureau takes final disciplinary action against an EMS agency or applicant, the bureau may publish notice of the action in a periodical, internet website, or other medium that has statewide distribution;

(2) the bureau may take immediate action to suspend an EMS agency's certification to prevent the EMS agency from operating in New Mexico if the bureau determines that the health and safety of the public would be jeopardized if it did not take such action; the suspended EMS agency shall be afforded the right to an expedited hearing in accordance with this rule;

(3) the bureau may take disciplinary action against an EMS agency, or may refuse to distribute EMS fund monies to an EMS agency, for any of the following reasons:
(a) knowingly allowing a person to perform emergency medical services in the state of New Mexico when the person is not licensed or otherwise authorized by the department of health to perform emergency medical services;

(b) any instance of inappropriate billing practices, including but not limited to the following:
(i) administering unnecessary treatment or supplies to a patient for the purpose of increasing the patient's bill;

(ii) charging for treatment or supplies not actually provided to a patient; and

(iii) engaging in medicare or medicaid fraud;

(c) financial insolvency of the EMS agency;

(d) fraud, deceit, or misrepresentation by an EMS agency in obtaining certification, including but not limited to misrepresentation during the initial or renewal certification process;

(e) expenditure of EMS fund monies in any manner or for any purpose not authorized by the bureau, or in any manner prohibited by the EMS Fund Act, NMSA 1978, Section 24-10A-1 et seq., or applicable rules (see 7.27.4 NMAC);

(f) loss of federal drug enforcement administration or NM board of pharmacy licensure or failure to notify the bureau of such loss of licensure;

(g) failure to ensure that the EMS agency receives and complies with medical direction that conforms to applicable medical direction guidelines (see 7.27.3 NMAC);

(h) failure to pay required certification fees or to pay an outstanding balance owed to the bureau;

(i) operating as an EMS agency in the state of New Mexico for any period of time without holding valid certification from the bureau, unless the EMS agency previously obtained an applicable waiver from the bureau;

(j) failure to implement reasonable infection control practices, failure to maintain a clean and hygienic work environment, or failure to properly maintain and dispose of biohazard material;

(k) failure to make a required submission to the bureau, including but not limited to the submission of patient run report data;

(l) permitting an individual who is not a student at bureau-approved or CoAEMSP-accredited EMS training program to perform as an intern with the EMS agency;

(m) the conviction of an EMS agency's principals of a felony or a misdemeanor, as shown by a copy of the record of the court conviction;

(n) failure of an EMS agency's principals to notify the bureau upon learning that an EMS provider has been convicted of a felony or misdemeanor while employed by the EMS agency;

(o) failure of an EMS agency to cooperate with a bureau investigation, including but not limited to failure to furnish the bureau with requested information, or failure of agency personnel to appear at an interview as requested;

(p) attempting, either directly or through an agent, to intimidate, threaten, injure or take any adverse action against a person for providing information to the bureau;

(q) conduct on the part of EMS agency personnel that constitutes a significant threat to the health or safety of individuals receiving emergency care;

(r) negligence on the part of EMS agency personnel in the delivery of emergency medical services, including but not limited to the following:
(i) malpractice or substandard medical care or treatment;

(ii) incompetence;

(iii) abandonment;

(iv) practicing without a valid NM EMT license; or performing outside an applicable standard of care/scope of practice;

(v) failure to retain, transport or use required equipment, or inappropriate use of equipment during treatment or transport of patients; or

(vi) unauthorized disclosure of medical or other confidential information;

(s) unprofessional conduct on the part of EMS agency personnel, including but not limited to the following:
(i) dissemination of a patient's health information to individuals not entitled to such information where such information is protected by law from disclosure;

(ii) falsification or alteration of patient records or EMS agency records;

(iii) misappropriation of money, drugs or property;

(iv) obtaining or attempting to obtain any fee for patient services for one's self or for another through fraud, misrepresentation, or deceit;

(v) aiding, abetting, assisting or hiring an individual to violate the EMS Act or these duly promulgated rules;

(vi) failure to follow established procedure and documentation regarding controlled substances;

(vii) failure to make or keep accurate, intelligible entries in records as required by law, policy and standards for the practice of pre-hospital emergency care;

(viii) failure to report an EMT who is suspected of violating the New Mexico EMS Act (NMSA 1978, Section 24-10B-4) or New Mexico licensing rules for EMS personnel (7.27.2 NMAC);

(ix) intentionally engaging in sexual contact with or toward a patient;

(t) failure of EMS agency personnel to report revocation, suspension, denial, or other adverse action relating to a license, permit, designation or certification taken in any other state or jurisdiction affecting the ability to provide emergency medical services in that state;

(u) the making of any false, fraudulent, or deceptive statement by EMS agency personnel in any document connected with EMS agency operations;

(v) the dispensation, administration, or distribution of any controlled substance (as defined in the New Mexico Controlled Substances Act, NMSA 1978, Section 30-31-1 et seq., other than a controlled substance authorized in an applicable scope of practice, by EMS agency personnel;

(w) willful and deliberate failure of EMS agency personnel to respond to a call;

(x) willful and deliberate failure of EMS agency personnel to transport a patient when required;

(y) except as otherwise provided in this rule, failure of EMS agency personnel to deliver a patient to the most appropriate medical facility as determined by the medical director, dependent upon the patient's medical needs; and

(z) failure to comply with any requirement of this rule;

(4) denial of certification for failure to properly apply or failure to pay a required fee shall not constitute a disciplinary action for purposes of this section, and shall not entitle an applicant to a hearing;

(5) the bureau's refusal to distribute EMS fund monies to an EMS agency shall not constitute a "disciplinary action" for purposes of this section, and an EMS agency that is refused a distribution of EMS fund monies shall not be entitled to a hearing under this section; an EMS agency may appeal the bureau's determination to refuse a distribution of EMS fund monies by following the appeal provisions of the EMS Fund Act rule, 7.27.4 NMAC.

E. Records management. A certification record is maintained for every certified EMS agency in New Mexico; any request for records maintained by the bureau shall be processed in accordance with the Inspection of Public Records Act, NMSA 1978, Section 14-2-1 et seq.

(1) Confidentiality of investigations. The bureau shall take every precaution to ensure that preliminary and formal investigations are conducted in a confidential manner. If the bureau initiates an action, all records not exempt from disclosure under the Inspection of Public Records Act, NMSA 1978, Section 14-2-1 et seq., shall be placed in the EMS agency's certification record, if one exists.

(2) Records confidentiality. Any files or records in the possession of the bureau, a regional office or a provider containing identifying information about individuals requesting or receiving treatment or other health services and any unsubstantiated complaints received by the bureau regarding any provider shall be confidential and not subject to public inspection; such files, records and complaints may be subject to subpoena for use in any pending cause, in any administrative proceeding, or in any of the courts of this state, unless otherwise provided by state or federal law.

F. Notice of contemplated action. When the bureau contemplates taking disciplinary action against an EMS agency or applicant, it shall serve upon the EMS agency or applicant a written notice containing a statement of the grounds or subject upon which the proposed action is based and identifying any rule(s) violated.

G. Injunctions. The department may apply to a district court of New Mexico to enjoin an EMS agency from engaging in business in the state.

Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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