New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 301 - MEDICAID GENERAL BENEFIT DESCRIPTION
Part 5 - MEDICAL MANAGEMENT
Section 8.301.5.10 - SERVICES EXCLUDED FROM MEDICAL MANAGEMENT

Recipients can receive emergency services and inpatient services without referrals from their designated providers. These services are exempt from medical management. Emergency room claims for services provided to any recipient may be reviewed before or after payment. Inappropriate nonemergency use of emergency room services results in denial of payment by medicaid and liability of the recipient for payment.