New Mexico Administrative Code
Title 8 - SOCIAL SERVICES
Chapter 310 - HEALTH CARE PROFESSIONAL SERVICES
Part 12 - INDIAN HEALTH SERVICE AND TRIBAL 638 FACILITIES
Section 8.310.12.9 - INDIAN HEALTH SERVICE AND TRIBAL 638 FACILITIES

HSD, through the medical assistance division (MAD), pays for medically necessary health services furnished to an eligible recipient, including American Indian and Alaska native (AI/AN) eligible recipients. The Indian health service (IHS) is a federal agency within the United States department of health and human services (DHHS) that is responsible for providing health services to AI/ANs based on the unique government-to-government relationship between federally recognized tribes and nations and the federal government. The IHS health care delivery system consists of health facilities owned and operated by IHS, facilities owned by IHS and operated by tribes or tribal organizations under Title I or Title III of the Indian Self-Determination and Education Assistance Act ( Public Law 93-638, as amended) agreements, and facilities owned and operated by tribes or tribal organizations under such agreements, hereafter referred to as "IHS and tribal 638 facilities". Pursuant to Section 1911 of the Social Security Act; see 42 U.S.C. 1369 j and the 1996 memorandum of agreement between IHS and the centers for medicare and medicaid services (CMS), IHS and tribal 638 facilities are eligible to be reimbursed by MAD for furnishing covered healthcare services to a MAP eligible AI/AN recipient (eligible recipient). Specific to this rule, an eligible recipient includes a member enrolled in a HSD contracted managed care organization (MCO).