N.M. Admin. Code § 8.325.10.12 - ELIGIBLE INDIVIDUALS
A. An
applicant must be a noncitizen who is undocumented or who does not meet the
qualifying immigration criteria specified in 8.200.410 NMAC, General
Recipient Requirements, and in 8.285.400 NMAC, Medicaid
Eligibility Emergency Medical Services for Non-Citizens-Category
085.
B. Eligibility
determinations are made by local county income support division (ISD) offices
after the receipt of emergency services. The individual is responsible for
completing an application at the local county ISD office and for providing all
necessary documentation to prove that they meet the applicable eligibility
criteria.
(1) An individual must apply for
coverage at the ISD office no later than the last day of the third month
following the month in which the alleged emergency services were
received.
(2) A noncitizen
recipient is responsible for notifying providers of the approval or denial of
an application.
(3) If an
application is denied or an application for coverage is not filed by the last
day of the third month following the month in which the alleged emergency
services were received, the non-citizen recipient is responsible for payment of
the provider bill.
(4) If
reimbursement for services is denied by MAD, the individual is responsible for
payment and can be billed directly for payment by the provider.
Notes
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