New Mexico Register / Volume XXXIII, Issue 7 / April 5, 2022
This is an amendment to 8.308.11 NMAC,
Sections 8 and 9, effective 4/5/2022.
8.308.11.8 [RESERVED] MISSION: To transform lives. Working with our partners, we design and deliver
innovative, high quality health and human services that improve the security
and promote independence for New Mexicans in their communities.
[8.308.11.8
NMAC - Rp, 8.308.11.8 NMAC, 5/1/2018; A, 4/5/2022]
8.308.11.9 TRANSITION
OF CARE: Transition of care refers to movement of an
eligible recipient or a manage care organization (MCO) member from one health
care practitioner or setting to another as [his or her] their
condition and health care needs change.
The MCO shall have the resources, the policies and the procedures in
place to actively assist the member with [his or her] their
transition of care.
A. Care
coordination will be offered to members who are:
(1) transitioning
from a nursing facility or out-of-home placement to the community;
(2) moving
from a higher level of care to a lower level of care (LOC);
(3) turning
21 years of age;
(4) changing
MCOs while hospitalized;
(5) changing
MCOs during major organ and tissue transplantation services; and
(6) changing
MCOs while receiving outpatient treatments for significant medical
conditions. A member shall continue to
receive medically necessary services in an uninterrupted manner during
transitions of care.
B. The following is
a list of HSD’s general MCO requirements for transition of care.
(1) The
MCO shall establish policies and procedures to ensure that each member is
contacted in a timely manner and is appropriately assessed by its MCO, using
the HSD prescribed timeframes, processes and tools to identify [his or her]
their needs.
(2) The
MCO shall have policies and procedures covering the transition of an eligible
recipient into a MCO, which shall include:
(a) member
and provider educational information about the MCO;
(b) self-care
and the optimization of treatment; and
(c) the
review and update of existing courses of the member’s treatment.
(3) The
MCO shall not transition a member to another provider for continuing services,
unless the current provider is not a contracted provider.
(4) The
MCO shall facilitate a seamless transition into a new service, a new provider,
or both, in a care plan developed by the MCO without disruption in the member’s
services.
(5) When
a member of a MCO is transitioning to another MCO, the receiving MCO shall immediately
contact the member’s relinquishing MCO and request the transfer of “transition
of care data” as specified by HSD. If a
MCO is contacted by another MCO requesting the transfer of “transition of care
data” for a transitioning member, then upon verification of such a transition,
the relinquishing MCO shall provide such data in the timeframe and format
specified by HSD to the receiving MCO, and both MCOs shall facilitate a
seamless transition for the member.
(6) The
receiving MCO will ensure that its newly transitioning member is held harmless
by [his or her] their provider for the costs of medically
necessary covered services, except for applicable cost sharing.
(7) For
a medical assistance division (MAD) medically necessary covered service provided
by a contracted provider, the MCO shall provide continuation of such services
from that provider, but may require prior authorization for the continuation of
such services from that provider beyond 30 calendar days. The receiving MCO may initiate a provider
change only as specified in the MCO agreement with HSD.
(8) The
receiving MCO shall continue providing services previously authorized by HSD,
its contractor or designee, in the member’s approved community benefit care plan,
behavioral health treatment plan or service plan without regard to whether such
a service is provided by contracted or non-contracted provider. The receiving MCO shall not reduce approved
services until the member’s care coordinator conducts a comprehensive needs
assessment (CNA).
C. Transplant
services, durable medical equipment and prescription drugs:
(1) If
an eligible recipient has received HSD approval, either through fee-for-service
(FFS) or any other HSD contractor, the receiving MCO shall reimburse the HSD
approved providers if a donor organ becomes available during the first 30
calendar days of the member’s MCO enrollment.
(2) If
a member was approved by a MCO for transplant services, HSD shall reimburse the
MCO approved providers if a donor organ becomes available during the first 30
calendar days of the eligible recipient’s FFS enrollment. The MCO provider who delivers these services
will be eligible for FFS enrollment if the provider is willing.
(3) If
a member received approval from [his or her] their MCO for
durable medical equipment (DME) costing [two thousand dollars ($2,000)] $2,000
or more, and prior to the delivery of the DME item, was disenrolled from the
MCO, the relinquishing MCO shall pay for the item.
(4) If
an eligible recipient received FFS approval for a DME costing [two thousand
dollars ($2,000)] $2,000 or more, and prior to the delivery of the
DME item, [he or she is] they are enrolled in a MCO, HSD shall
pay for the item. The DME provider will
be eligible for FFS provider enrollment if the provider is willing.
(5) If
a FFS eligible recipient enrolls in a MCO, the receiving MCO shall pay for
prescribed drug refills for the first 30 calendar days or until the MCO makes
other arrangements.
(6) If
a MCO member is later determined to be exempt from MCO enrollment, HSD will pay
for prescription drug refills for the first 30 calendar days of [his or her]
their FFS enrollment. The
pharmacy provider will be eligible for FFS enrollment if the provider is
willing;
(7) If
a FFS eligible recipient is later enrolled in a MCO, the receiving MCO will
honor all prior authorizations granted by HSD or its contractors for the first
30 calendar days or until it makes other arrangements for the transition of
services. A provider who delivered
services approved by HSD or through its contractors shall be reimbursed by the
receiving MCO.
(8) If
a MCO member is later determined to be exempt from MCO enrollment, HSD will
honor the relinquishing MCO’s prior authorizations for the first 30 calendar
days or until other arrangements for the transition of services have been
made. The provider will be eligible for
FFS enrollment if the provider is willing.
D. Transition of
care requirements for pregnant [women] individuals:
(1) When
a member is in [her] their second or third trimester of pregnancy
and is receiving medically necessary covered prenatal care services prior to [her]
their enrollment in the MCO, the receiving MCO will be responsible for
providing continued access to [her] their prenatal care provider
(whether a contracted or non-contracted provider) through the [two month]
12-month postpartum period without any form of prior approval.
(2) When
a newly enrolled member is in [her] their first trimester of
pregnancy and is receiving medically necessary covered prenatal care services
prior to [her] their enrollment, the receiving MCO shall be
responsible for the costs of continuation of such medically necessary prenatal
care services, including prenatal care and delivery, without any form of prior
approval from the receiving MCO and without regard to whether such services are
being provided by a contracted or non-contracted provider for up to 60 calendar
days from [her] their MCO enrollment or until [she] they
may be reasonably transferred to a MCO contracted provider without disruption
in care, whichever is less.
(3) When
a member is receiving services from a contracted provider, [her] their
MCO shall be responsible for the costs of continuation of medically necessary covered
prenatal services from that provider, without any form of prior approval,
through the [two month] 12-month postpartum period.
(4) When
a member is receiving services from a non-contracted provider, [her] their
MCO will be responsible for the costs of continuation of medically necessary
covered prenatal services, delivery, through the [two month] 12-month
postpartum period, without any form of prior approval, until such time when [her]
their MCO determines it can reasonably transfer [her] them
to a contracted provider without impeding service delivery that might be
harmful to [her] their health.
E. Transition from
institutional facility to community:
(1) The
MCO shall develop and implement methods for identifying members who may have
the ability, the desire, or both, to transition from institutional care to [his
or her] their community, such methods include, at a minimum:
(a) the
utilization of a CNA;
(b) the
utilization of the preadmission screening and annual resident review (PASRR);
(c) minimum
data set (MDS);
(d) a
provider referral including hospitals, and residential treatment centers;
(e) an
ombudsman referral;
(f) a
family member referral;
(g) a
change in medical status;
(h) the
member’s self-referral;
(i) community
reintegration allocation received;
(j) state
agency referral; and
(k) incarceration
or detention facility referral.
(2) When
a member’s transition assessment indicates that [he or she is] they
are a candidate for transition to the community, [his or her] their
MCO care coordinator shall facilitate the development and completion of a
transition plan, which shall remain in place for a minimum of 60 calendar days
from the decision to pursue transition or until the transition has occurred and
a new care plan is in place. The
transition plan shall address the member’s transition needs including but not
limited to:
(a) [his
or her] their physical and behavioral health needs;
(b) the
selection of providers in [his or her] their community;
(c) continuation
of MAP eligibility;
(d) [his
or her] their housing needs;
(e) [his
or her] their financial needs;
(f) [his
or her] their interpersonal skills; and
(g) [his
or her] their safety.
(3) The
MCO shall conduct an additional assessment within 75 calendar days of the
member’s transition to [his or her] their community to determine
if the transition was successful and identify any remaining needs of the
member.
F. Transition from
the New Mexico health insurance exchange:
(1) The
receiving MCO must minimize the disruption of the newly enrolled member’s care
and ensure [he or she has] they have uninterrupted access to
medically necessary services when transitioning between a MCO and [his or
her] their New Mexico health insurance exchange qualified health
plan coverage.
(2) At
a minimum, the receiving MCO shall establish transition guidelines for the
following populations:
(a) pregnant
members, including the [two month] 12-month postpartum period;
(b) members
with complex medical conditions;
(c) members
receiving ongoing services or who are hospitalized at the time of transition;
and
(d) members
who received prior authorization for services from their qualified health plan.
(3) The
receiving MCO is expected to coordinate services and provide phase-in and
phase-out time periods for each of these populations, and to maintain written
policies and procedures to address these coverage transitions.
[8.308.11.9
NMAC - Rp, 8.308.11.9 NMAC, 5/1/2018; A, 4/5/2022]