N.M. Admin. Code § 8.231.400.10 - BASIS FOR DEFINING THE GROUP (42 CFR 435.177)
A.
Eligibility: HSD provides
medicaid to children from birth through the month of the child's first birthday
without application if, for the date of the child's birth, the child's mother
was eligible for and received covered services under:
(1) the medicaid state plan (including during
a period of retroactive eligibility under
42 CFR 435.915)
regardless of whether payment for services for the mother is limited to
services necessary to treat an emergency medical condition, as defined in
section 1903(v)(3) of the Act and
8.285.400.10 NMAC under the
emergency medical services for non-citizens (EMSNC) program.
(2) the child is deemed to have applied and
been determined eligible under the medicaid state plan effective as of the date
of birth, and remains eligible regardless of changes in circumstances through
the month of the child's first birthday, unless the child dies or ceases to be
a resident of the state or the child's representative requests a voluntary
termination of eligibility.
B.
Medicaid identification
number: The medicaid identification number of the mother serves as the
child's identification number, and all claims for covered services provided to
the child may be submitted and paid under such number, unless and until the
state issues the child a separate identification number. HSD will issue a
separate medicaid identification number for the child prior to the effective
date of any termination of the mother's eligibility or prior to the date of the
child's first birthday, whichever is sooner, except that HSD will issue a
separate medicaid identification number in the case of a child born to a
mother:
(1) whose coverage is limited to
services necessary for the treatment of an emergency medical condition,
consistent with
42 CFR
435.139 or
435.350
and 8.285.400.10 NMAC under the EMSNC program; or
(2) who received medicaid in another state on
the date of birth.
Notes
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