New Mexico Administrative Code
Title 7 - HEALTH
Chapter 30 - FAMILY AND CHILDREN HEALTH CARE SERVICES
Part 3 - CHILDREN'S MEDICAL SERVICES AND ADULT CYSTIC FIBROSIS
Section 7.30.3.15 - OUT-OF-STATE PROVIDER POLICY
Universal Citation: 7 NM Admin Code 7.30.3.15
Current through Register Vol. 35, No. 18, September 24, 2024
Services must be purchased within the state of NM, unless the need to purchase services elsewhere is documented and approved by the CMS medical director.
A. Services may be purchased outside the state of NM when:
(1)
the specific service is not available in NM; or
(2) an eligible client is temporarily out of
state and does not qualify for medical assistance in the state of temporary
residence, and the health of the client would be endangered if services were
postponed until return to NM or by travel to NM; or
(3) excessive time, distance, and expense
would be involved in order to obtain outpatient services in NM. Inpatient
services are eligible out of state if urgent or emergency hospitalization is
needed when distance is excessive or in-state tertiary centers are
full.
B. Services may not, under any circumstances, be purchased out of state without approval of the medical director or designee.
C. Out-of-state providers are subject to the same fee schedule, time limitations, standards, and requirements, including operating under a provider agreement, as in-state providers.
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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