N.M. Admin. Code § 8.325.9.10 - ELIGIBLE PROVIDERS
A.
Upon approval of New Mexico medical assistance program provider participation
agreements by the New Mexico medical assistance division (MAD), home health
agencies that meet the following conditions are eligible to be reimbursed for
furnishing services:
(1) meet the conditions
of participation. See 42 CFR, Section 484 Subpart B;
(2) are licensed and certified by the
licensing and certification bureau of the HCA to meet all standards for
participation in a federal program established under Title XVIII (medicare) of
the Social Security Act. Any provider participating only in medicaid must be
licensed and certified to comply with the standards for medicare participation;
and
(3) are public agencies,
private for-profit agencies, or private non-profit agencies primarily engaged
in furnishing skilled nursing services and at least one other therapeutic
service.
B. Once
enrolled, providers receive a packet of information, including medicaid program
policies, billing instructions, utilization review instructions and other
pertinent material from MAD. Providers are responsible for ensuring that they
have received these materials and for updating them as new materials are
received from MAD.
Notes
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