N.M. Admin. Code § 8.315.2.10

Current through Register Vol. 35, No. 20, October 22, 2024

Section 8.315.2.10 - ELIGIBLE PROVIDERS

A. The eligible provider will have a professional services agreement (PSA) with the HCA. The provider will also meet the following conditions:

(1) be licensed and certified by the licensing and certification bureau of the department of health (DOH) to meet conditions as a diagnostic and treatment center;

(2) participate in the MAD utilization review process and agree to operate in accordance with all policies and procedures of that system; and

(3) meet and comply with the centers for medicare and medicaid services (CMS) requirements for full provider status for PACE organizations.

B. Once enrolled, the provider will receive a packet of information, including medicaid program policies, utilization review instructions, and other pertinent material from MAD. The provider is responsible for ensuring receipt of these materials and for updating as new materials are received from MAD.

N.M. Admin. Code § 8.315.2.10

8.315.2.10 NMAC - Rp, 8 NMAC 4.MAD.777.1, 12-1-06, Adopted by New Mexico Register, Volume XXXV, Issue 12, June 25, 2024, eff. 7/1/2024