N.M. Admin. Code § 8.324.7.13 - NONCOVERED SERVICES
Transportation services are subject to the same limitations and coverage restrictions that exist for other MAD services. See 8.301.3 NMAC. Payments for transportation for any non-covered service is subject to retroactive recoupment.
A. MAD does
not pay to transport a MAP eligible recipient to a medical or behavioral health
service or provider that is not covered under the MAD program.
B. A provider will not be eligible to seek
reimbursement from a MAP eligible recipient if the provider fails to notify the
MAP eligible recipient or his or her authorized representative that the service
is not covered by MAD. See 8.302.1 NMAC.
C. Transportation services will not be
provided when other alternatives are available, such as mail delivery or free
delivery. Retail pharmacies may mail, ship or deliver prescriptions to medicaid
recipients consistent with applicable state and federal statutes and
regulations.
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