New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 200 - MEDICAID ELIGIBILITY - GENERAL RECIPIENT POLICIES
Part 430 - RECIPIENT RIGHTS AND RESPONSIBILITIES
Section 8.200.430.18 - REPORTING REQUIREMENTS
Current through Register Vol. 35, No. 18, September 24, 2024
A medicaid eligible recipient is required to report certain changes which might affect his or her eligibility to ISD within 10 calendar days from the date the change occurred. A timely change that is reported within 10 calendar days that may result in a more beneficial medicaid eligibility category shall be evaluated in the month the change occurred. An untimely change that is reported after 10 calendar days that may result in a more beneficial medicaid eligibility category shall be evaluated in the month the change was reported. A reported change that does not result in the same or a more beneficial medicaid category is considered an adverse action and is applied prospectively in accordance with 8.100.180.10 NMAC. See 8.100.110.9 NMAC for the various ways applicants and recipients can submit changes to the HSD. The following changes must be reported to ISD:
A. Living arrangements or change of address: Any change in where an eligible recipient lives or gets his or her mail must be reported.
B. Household size: Any change in the household size must be reported. This includes the death of an individual included in the either or both the assistance unit and budget group.
C. Enumeration: Any new social security number must be reported.
D. Income: Except for continuous eligibility in 8.200.400 NMAC any increase or decrease in the amount of income or change in the source of income must be reported.
E. Resource: Resources only apply to non-modified adjusted gross income (MAGI) medicaid categories. Any change in what an eligible recipient owns must be reported. This includes any property the eligible recipient owns or has interest in, cash on hand, money in banks or credit unions, stocks, bonds, life insurance policies or any other item of value.
