N.M. Admin. Code § 8.325.10.13 - COVERAGE CRITERIA
A.
"Emergency" as defined for EMSA includes labor and delivery including
inductions and cesarean sections, as well as any other medical condition,
manifesting itself with acute symptoms of sufficient severity such that the
absence of immediate emergency medical attention could reasonably be expected
to result in one of the following:
(1) the non
citizen recipient's death;
(2)
placement of the non-citizen recipient's health in serious jeopardy;
(3) serious impairment of bodily functions;
or
(4) serious dysfunction of any
bodily organ or part.
B.
Services are covered only when necessary to treat or evaluate a condition
meeting the definition of emergency and are covered only for the duration of
that emergency.
C. After delivery,
a child can have legally documented or citizenship status because of its birth
in the United States and, therefore, is not eligible for emergency services for
non-citizens. The child may be eligible for another MAD category of eligibility
on their own.
D. Determination of
coverage is made by MAD or its designee.
Notes
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