N.M. Admin. Code § 8.290.400.12 - SPECIAL RECIPIENT REQUIREMENTS
A.
Age: To be considered
elderly, an applicant/recipient must be 65 years of age or older. See Section
8.281.400.16 NMAC, AGE, for
information on verification of age.
B.
Blind: To be considered
blind, an applicant/recipient must have central visual acuity of 20/200 or less
with corrective lenses or must be considered blind for practical purposes. The
ISD worker is responsible for submitting medical reports to the DDU, if
necessary. See Section
8.281.400.17 NMAC,
Blind, For Information on documentation and verification of
blindness.
C.
Disability: To be considered disabled, an applicant/recipient must
be unable to engage in any substantial gainful activity because of any medical
determinable physical, developmental, or mental impairment, which has lasted,
or is expected to last, for a continuous period of at least 12 months. The ISD
worker is responsible for submitting medical reports to the DDU, if necessary.
See Section
8.281.400.18 NMAC,
Disability, for information on documentation and verification
of disability.
D.
Requires
institutional care: An institutional level of care must be recommended
for the applicant/recipient by a physician, nurse practitioner or a doctor of
osteopathy, licensed to practice in the state of New Mexico. Institutions are
defined as acute care hospitals, nursing facilities (either high NF or low NF
as defined by medicaid regulations) and ICF/IID. Level of care reviews are
completed by the medical assistance division (MAD) utilization review
contractor or a member's selected or assigned managed care organization (MCO),
as applicable to the applicant's HCBS program.
Notes
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