New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 291 - MEDICAID ELIGIBILITY - AFFORDABLE CARE
Part 400 - ELIGIBILITY REQUIREMENTS
Section 8.291.400.12 - REPORTING REQUIREMENTS

Universal Citation: 8 NM Admin Code 8.291.400.12

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

A medicaid eligible recipient is required to report certain changes which might affect their 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 individual lives or receives 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 assistance unit or budget group;

C. enumeration: any new social security number must be reported; or

D. income: any increase or decrease in the amount of income or change in the source of income must be reported.

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