New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 310 - HEALTH CARE PROFESSIONAL SERVICES
Part 12 - INDIAN HEALTH SERVICE AND TRIBAL 638 FACILITIES
Section 8.310.12.13 - PRIOR AUTHORIZATION AND UTILIZATION REVIEW
Universal Citation: 8 NM Admin Code 8.310.12.13
Current through Register Vol. 35, No. 18, September 24, 2024
IHS and tribal 638 facilities need not obtain prior authorization for services, but must continue to follow standards of care within its scope of practice and retain documentation in the eligible recipient's physical and behavioral health record. MAD services are subject to utilization review for medical necessity and program compliance. Reviews may be performed before or after services are furnished.
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