New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 291 - MEDICAID ELIGIBILITY - AFFORDABLE CARE
Part 410 - GENERAL RECIPIENT REQUIREMENTS
Section 8.291.410.24 - USE OF INFORMATION AND REQUESTS OF ADDITIONAL INFORMATION FROM INDIVIDUALS (42 CFR 435.952)
Current through Register Vol. 35, No. 18, September 24, 2024
A. HSD will promptly evaluate information received or obtained by it in accordance with regulations per 42 CFR 435.940 through 435.960 to determine whether such information may affect the eligibility of an individual or the benefits to which he or she is entitled.
B. If information provided by or on behalf of an individual (on the application or renewal form or otherwise) is reasonably compatible with information obtained by HSD in accordance with 42. CFR 435.948, 435.949 or 435.956 HSD will determine or renew eligibility based on such information.
C. An individual must not be required to provide additional information or documentation unless information needed by the agency HSD in accordance with 42 CFR 435.948, 435.949 or 435.956 cannot be obtained electronically or the information obtained electronically is not reasonably compatible, as provided in the verification plan described in 8.291.410.24 NMAC with information provided by or on behalf of the individual.
D. HSD may not deny or terminate eligibility or reduce benefits for any individual on the basis of information received in accordance with regulations under 42 CFR 435.940 through 435.960 of this subpart unless HSD has sought additional information from the individual in accordance with Subsection C of 8.291.410.24 NMAC and provided proper notice and hearing rights to the individual.