New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 302 - MEDICAID GENERAL PROVIDER POLICIES
Part 3 - RECIPIENT POLICIES -GENERAL RECIPIENT REQUIREMENTS
Section 8.302.3.14 - PROVIDER LIENS ON PERSONAL INJURY AWARDS
Universal Citation: 8 NM Admin Code 8.302.3.14
Current through Register Vol. 35, No. 18, September 24, 2024
A. Hospital liens: Hospitals are prohibited from imposing liens on potential lawsuit recoveries for the difference between the MAD payment and hospital billed amounts. MAD payment amounts are payment in full.
(1) Hospitals
furnishing services to eligible recipients who have been injured in accidents
may choose to file claims with MAD or forego medicaid reimbursement and file
hospital liens against any potential lawsuit recoveries.
(2) If hospitals choose to bill medicaid,
they must file claims within 120 calendar days of the date of
discharge.
(3) If hospitals choose
to impose a lien, they cannot bill eligible recipients or medicaid for any
unpaid balance remaining after future settlement or lack of
settlement.
(4) If hospitals file
claims with MAD, the amounts received are payment in full.
B. Non-hospital providers: For non-hospital providers, medicaid payments are payment in full for medical services furnished to eligible recipients injured in accidents caused by other parties. Providers may not seek additional payment for these services from eligible recipients, even if eligible recipients later receive monetary awards or settlements from liable parties.
Disclaimer: These regulations may not be the most recent version. New Mexico may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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