New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 171 - PREMIUM ASSISTANCE FOR CHILDREN (CATEGORY 071/2)
Part 400 - RECIPIENT POLICIES
Section 8.171.400.7 - DEFINITIONS
Current through Register Vol. 35, No. 6, March 26, 2024
A. Action: The denial or limited authorization of a requested service, including the type or level of service; the reduction, suspension, modification, or termination of a previously authorized service; the denial, in whole or in part, of payment for a service; or a failure to provide a service in a timely manner. An untimely service authorization constitutes a denial and is thus considered an action.
B. Administrative hearing: An evidentiary hearing conducted so that evidence can be presented.
C. Certification of comprehensive health plan: The process by which the human services department (HSD) certifies an insurance plan as a comprehensive plan eligible for participation in the premium assistance program.
D. Enumeration: The process by which the federal government assigns a social security number.
E. Overpayments: Erroneous payments or payment made on behalf of an individual was not eligible.
F. Sibling group: Siblings, including half- or step-siblings, living in the same household.
