Current through Register Vol. 35, No. 18, September 24, 2024
As a condition of MAP eligibility, HSD requires an applicant
or a re-determining eligible recipient to assign his or her medical care
support rights to HSD for medical support and any third party payments. The
assignment authorizes HSD to pursue and make recoveries from liable third
parties (
42 CFR
433.146; NMSA 1978 27-2-28(G)).
A.
Assigning medical support
rights: The assignment to HSD of an eligible recipient's rights to
medical support and payments occurs automatically under New Mexico law when the
applicant or the re-determining eligible recipient signs the application.
B. Third party liability (TPL): This section
describes HSD's responsibility to identify and collect from primarily
responsible third parties and the eligible recipient's responsibility to
cooperate with HSD to uncover such payments. MAD is the payer of last resort.
If other third party resources are available, these health care resources must
be used before MAD makes a reimbursement. As a condition of MAP eligibility, an
applicant assigns his or her rights to physical and behavioral health support
and payments to HSD and promises to cooperate in identifying, pursuing, and
collecting payments from these resources. Third party resources include the
gross recovery by eligible recipient, including personal injury protection
benefits, before any reduction in attorney's fees or costs, obtained through
settlement or verdict, for personal injury negligence or intentional tort
claims or actions, up to the full amount of MAD payments for treatment of
injuries causally related to the occurrence that is the subject of the claim or
action.
(1) Required TPL information:
During the initial determination or re-determination of eligibility for MAP
enrollment, ISD must obtain information about TPL from either the applicant or
the re-determining eligible recipient.
(a) HSD
is required to take all reasonable measures to determine the legal liability of
third parties, including health insurers in paying for the physical and
behavioral health services furnished to an eligible recipient (
42 CFR
433.138(a)) .
(b) HSD uses the information collected at the
time of determination in order for MAD to pursue claims against third
parties.
(2)
Availability of health insurance: If an applicant or an eligible recipient has
health insurance, the applicant or the eligible recipient shall notify ISD. ISD
must collect all relevant information, including name and address of the
insurance company; individuals covered by the policy, effective dates, covered
services, and appropriate policy numbers.
(a)
An applicant or an eligible recipient with health insurance coverage or
coverage by a health maintenance organization (HMO) or other managed care plan
(plan) must be given a copy of the TPL recipient information letter.
(b) If there is an absent parent, ISD may
request the absent parent's name and social security number (SSN).
(c) ISD must determine if an absent parent,
relative, applicant or any member of the household is employed and has health
insurance coverage.
(3)
Eligible recipients with health insurance coverage: An applicant or an eligible
recipient must inform his or her MAD providers of his or her TPL. An applicant
or an eligible recipient must report changes to or terminations of insurance
coverage to ISD. If an applicant or an eligible recipient has health coverage
through an HMO or plan, payment from MAD is limited to applicable copayments
required under the HMO or plan and to MAD covered services documented in
writing as exclusions by the HMO or plan.
(a)
If the HMO or plan uses a drug formulary, the medical director of the HMO or
plan must sign and attach a written certification for each drug claim to
document that a pharmaceutical product is not covered by the HMO or plan. The
signature is a certification that the HMO or plan drug formulary does not
contain a therapeutic equivalent that adequately treats the physical or
behavioral health condition of the HMO or plan subscriber.
(b) Physical and behavioral health services
not included in the HMO or plan are covered by MAD only after review of the
documentation and on approval by MAD.
(c) An applicant or an eligible recipient
covered by an HMO or plan is responsible for payment of medical services
obtained outside the HMO or plan and for medical services obtained without
complying with the rules or policies of the HMO or plan.
(d) An applicant or an eligible recipient
living outside an HMO or plan coverage area may request a waiver of the
requirement to use HMO or plan providers and services. The applicant or the
eligible recipient for whom a coverage waiver is approved by MAD may receive
reimbursement for expenses which allow him or her to travel to an HMO or plan
participating provider, even when the provider is not located near the
applicant or the eligible recipient's residence.
(4) Potential health care resources: ISD must
evaluate the presence of a TPL source if certain factors are identified during
the MAD eligibility interview.
(a) When the
age of the applicant or the eligible recipient is over 65 years old medicare
must be explored. A student, especially a college student, may have health or
accident insurance through his or her school.
(b) An application on behalf of deceased
individual must be examined for "last illness" coverage through a life
insurance policy.
(c) Certain
specific income sources are indicators of possible TPL which include:
(i) railroad retirement benefits and social
security retirement or disability benefits indicating eligibility for Title
XVIII (medicare) benefits;
(ii)
workers' compensation (WC) benefits paid to employees who suffer an injury or
accident caused by conditions arising from employment; these benefits may
compensate employees for physical and behavioral health expenses and lost
income; payments for physical and behavioral health expenses may be made as
physical and behavioral health bills are incurred or as a lump sum
award;
(iii) black lung benefits
payable under the coal mine workers' compensation program, administered by the
federal department of labor (DOL), can produce benefits similar to railroad
retirement benefits if the treatment for illness is related to the diagnosis of
pneumoconiosis; beneficiaries are reimbursed only if services are rendered by
specific providers, authorized by the DOL; black lung payments are made monthly
and physical and behavioral health expenses are paid as they are incurred;
and
(iv) Title IV-D support
payments or financial support payments from an absent parent may indicate the
potential for physical and behavioral health support; if a custodial party does
not have health insurance that meets a minimum standard, the court in a
divorce, separation or custody and support proceeding may order the parent(s)
with the obligation of support to purchase insurance for the eligible recipient
child (
45 CFR
303.31(b)(1); NMSA 1978,
Section 40-4C-4(A)(1)); insurance can be obtained through the parent's
employer or union (NMSA 1978, Section 40-4C-4(A)(2)); parents may be ordered
to pay all or a portion of the physical and behavioral health expenses; for
purposes of physical l and behavioral health support, the minimum standards of
acceptable coverage, deductibles, coinsurance, lifetime benefits, out-of-pocket
expenses, co-payments, and plan requirements are the minimum standards of
health insurance policies and managed care plans established for small
businesses in New Mexico; see New Mexico insurance code.
(d) An applicant or an eligible recipient has
earned income: Earned income may indicate physical, behavioral health and
health insurance made available by an employer.
(e) Work history or military services: Work
history may indicate eligibility for other cash and physical and behavioral
benefits. Previous military service suggests the potential for veterans
administration (VA) or department of defense (DOD) health care, including the
civilian health and the medical program of the United States (CHAMPUS), for
individuals who reside within a 40-mile radius of a military health care
facility. An applicant or an eligible recipient who is eligible for DOD health
care must obtain certification of non-availability of medical services from the
base health benefits advisor in order to be eligible for CHAMPUS.
(f) An applicant or an eligible recipient's
expenses show insurance premium payments: Monthly expense information may show
that the applicant or the eligible recipient pays private insurance premiums or
is enrolled in an HMO or plan.
(g)
The applicant or the eligible recipient has a disability: Disability
information contained in applications or brought up during interviews may
indicate casualties or accidents involving legally responsible third
parties.
(h) The applicant or the
eligible recipient has a chronic disease: Individuals with chronic renal
disease are probably entitled to medicare. Applications for social security
disability may be indicative of medicare coverage.
(5) Communicating TPL information:
Information concerning health insurance or health plans is collected and
transmitted to MAD by ISD, child support enforcement division (CSED), SSA, and
the children, youth and families department (CYFD).