N.M. Admin. Code § 8.281.600.12 - ONGOING BENEFITS
A complete redetermination of eligibility must be performed by the ISD worker for each open case at least annually.
A.
Regular reviews: For each
regular yearly review, the ISD worker must determine:
(1) whether medical care credit payments are
up to date; an overdue balance may indicate a change in circumstances that is
unreported, particularly where rental property is involved; and
(2) whether the deposit to the recipient's
personal fund is consistently no more than the applicable personal needs
allowance amount per month; a larger deposit may indicate an increase in income
that is unreported or a previously unidentified source of income.
B. Level of care reviews are
required to be completed at least annually. Level of care determinations are
made by the utilization review contractor or a member's selected or assigned
managed care organization.
Notes
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