New Mexico Register / Volume XXXV, Issue 14 / July 30, 2024

 

 

This is an amendment to 8.200.510 NMAC, Sections 1, 8, 11, 12, 13 and 15 effective 8/1/202024.

 

8.200.510.1          ISSUING AGENCY:  New Mexico [Human Services Department (HSD)] Health Care Authority (HCA).

[8.200.510.1 NMAC - Rp, 8.200.510.1 NMAC, 7/1/2015; A, 8/1/2024]

 

8.200.510.8          MISSION STATEMENT:  [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.] We ensure that New Mexicans attain their highest level of health by providing whole-person, cost effective, accessible, and high-quality health care and safety-net services.

[8.200.510.8 NMAC - Rp, 8.200.510.8 NMAC, 7/1/2015; A/E, 3/1/2017; A/E, 1/16/2020, A, 8/1/2024]

 

8.200.510.11        COMMUNITY SPOUSE RESOURCE ALLOWANCE (CSRA):  The CSRA standard varies based on when the applicant or recipient become institutionalized for a continuous period.  The CSRA remains constant even if it was calculated prior to submission of a formal MAP application.  If institutionalization began:

                A.            Between September 30, 1989 and December 31, 1989, the state maximum CSRA is $30,000 and the federal maximum CRSA is $60,000.

                B.            On or after January 1, 1990, the state minimum is $31,290 and the federal maximum CSRA is $62,580.

                C.            On or after January 1, 1991, the state minimum is $31,290 and the federal maximum CSRA is $66,480.

                D.            On or before January 1, 1992, the state minimum is $31,290 and the federal maximum CSRA is $68,700.

                E.            On or after January 1, 1993, the state minimum is $31,290 and the federal maximum CSRA is $70,740.

                F.            On or after January 1, 1994, the state minimum is $31,290 and the federal maximum CSRA is $72,660.

                G.            On or after January 1, 1995, the state minimum is $31,290 and the federal maximum CSRA is $74,820.

                H.            On or after January 1, 1996, the state minimum is $31,290 and the federal maximum CSRA is $76,740.

                I.             On or after January 1, 1997, the state minimum is $31,290 and the federal maximum CSRA is $79,020.

                J.             On or after January 1, 1998, the state minimum is $31,290 and the federal maximum CSRA is $80,760.

                K.            On or after January 1, 1999, the state minimum is $31,290 and the federal maximum CSRA is $81,960.

                L.            On or after January 1, 2000, the state minimum is $31,290 and the federal maximum CSRA is $84,120.

                M.           On or after January 1, 2001, the state minimum is $31,290 and the federal maximum CSRA is $87,000.

                N.            On or after January 1, 2002, the state minimum is $31,290 and the federal maximum CSRA is $89,280.

                O.            On or after January 1, 2003, the state minimum is $31,290 and the federal maximum CSRA is $90,660.

                P.            On or after January 1, 2004, the state minimum is $31,290 and the federal maximum CSRA is $92,760.

                Q.            On or after January 1, 2005, the state minimum is $31,290 and the federal maximum CSRA is $95,100.

                R.            On or after January 1, 2006, the state minimum is $31,290 and the federal maximum CSRA is $99,540.

                S.             On or after January 1, 2007, the state minimum is $31,290 and the federal maximum CSRA is $101,640.

                T.            On or after January 1, 2008, the state minimum is $31,290 and the federal maximum CSRA is $104,400.

                U.            On or after January 1, 2009, the state minimum is $31,290 and the federal maximum CSRA is $109,560.

                V.            On or after January 1, 2010, the state minimum is $31,290 and the federal maximum CSRA remains $109,560.

                W.           On or after January 1, 2011, the state minimum is $31,290 and the federal maximum CSRA remains $109,560.

                X.            On or after January 1, 2012, the state minimum is $31,290 and the federal maximum CSRA is $113,640.

                Y.            On or after January 1, 2013, the state minimum is $31,290 and the federal maximum CSRA is $115,920.

                Z.            On or after January 1, 2014, the state minimum is $31,290 and the federal maximum CSRA is $117,240.

                AA.         On or after January 1, 2015, the state minimum is $31,290 and the federal maximum CSRA is $119,220.

                BB.         On or after January 1, 2016, the state minimum is $31,290 and the federal maximum CSRA is $119,220.

                CC.         On or after January 1, 2017, the state minimum is $31,290 and the federal maximum CSRA is $120,900.

                DD.         On or after January 1, 2018, the state minimum is $31,290 and the federal maximum CSRA is $123,600.

                EE.         On or after January 1, 2019, the state minimum is $31,290 and the federal maximum CSRA is $126,420.

                FF.          On or after January 1, 2020, the state minimum is $31,290 and the federal maximum CSRA is $128,640.

                GG.        On or after January 1, 2021, the state minimum is $31,290 and the federal maximum CSRA is $130,380.

                HH.        On or after January 1, 2022, the state minimum is $31,290 and the federal maximum CSRA is $137,400.

                II.            On or after January 1, 2023, the state minimum is $31,290 and the federal maximum CSRA is $148,620.

                JJ.          On or after January 1, 2024, the state minimum is $31,290 and the federal maximum CSRA is $154,140.

[8.200.510.11 NMAC - Rp, 8.200.510.11 NMAC, 7/1/2015; A/E, 1/1/2016; A/E, 3/1/2017; A/E, 8/30/2018; A/E, 4/11/2019; A, 7/30/2019; A/E, 8/11/2020; A, 12/15/2020; A/E, 4/1/2021; A, 9/1/2021; A/E, 4/1/2022; A, 8/9/2022; A/E, 4/1/2023; A/E, 4/1/2024; A, 8/1/2024]

 

8.200.510.12        POST-ELIGIBILITY CALCULATION (MEDICAL CARE CREDIT):  Apply applicable deductions in the order listed below when determining the medical care credit for an institutionalized spouse.

                DEDUCTION                                                                                      AMOUNT

                A.            Personal needs allowance for institutionalized spouse:

                                [July 1, 2022]                                                                       [$83]

                                July 1, 2023                                                                          $91

                B.            Minimum monthly maintenance needs allowance (MMMNA):

                                [July 1, 2022]                                                                       [$2,289]

                                July 1, 2023                                                                          $2,465

                C.            The community spouse monthly income allowance (CSMIA) is calculated by subtracting the community spouse's gross income from the MMMNA:

                                (1)           If allowable shelter expenses of the community spouse exceeds the minimum allowance then deduct an excess shelter allowance from community spouse's income that includes: expenses for rent; mortgage (including interest and principal); taxes and insurance; any maintenance charge for a condominium or cooperative; and an amount for utilities (if not part of maintenance charge above); use the standard utility allowance (SUA) deduction used in the food stamp program for the utility allowance.

                                                [July 1, 2022                                                        $687]

                                                July 1, 2023                                                          $740

                                (2)           Excess shelter allowance may not exceed the maximum:

                                                [(a)          Jan. 1, 2023                                          $1,427

                                                (b)           Jan. 1, 2022                                          $1,257

                                                (c)           Jan. 1, 2021                                          $1,105

                                                (d)           July 1, 2020                                          $1,062

                                                (e)           Jan. 1, 2020                                          $1,103]

                                                (a)           Jan. 1, 2024                                          $1,388.50

                                                (b)           July 1, 2023                                          $1,251

                                                (c)           Jan. 1, 2023                                          $1,427

                                                (d)           July 1, 2022                                          $1,146

                                                (e)           Jan. 1, 2022                                          $1,257

                                                (f)            July 1, 2021                                          $1,082

                                                (g)           Jan. 1, 2021                                          $1,105

                D.            Any extra maintenance allowance ordered by a court of jurisdiction or a state administrative hearing officer.

                E.            Dependent family member income allowance (if applicable) calculated as follows:  1/3 X MMMNA - dependent member's income).

                F.            Non-covered medical expenses.

                G.            The maximum total of the community spouse monthly income allowance and excess shelter deduction may not exceed [$3,716] $3,853.50.

[8.200.510.12 NMAC - Rp, 8.200.510.12 NMAC, 7/1/2015; A/E, 3/1/2017; A/E. 8/30/2018; A/E, 4/11/2019; A, 7/30/2019; A/E, 1/16/2020; A/E, 8/11/2020; A, 12/15/2020; A/E, 4/1/2021; A, 9/1/2021; A/E, 4/1/2022; A, 8/9/2022; A/E, 4/1/2023; A/E, 4/1/2024; A, 8/1/2024]

 

8.200.510.13        AVERAGE MONTHLY COST OF NURSING FACILITIES FOR PRIVATE PATIENTS USED IN TRANSFER OF ASSET PROVISIONS:  Costs of care are based on the date of application registration.

                                DATE                                                                                                    AVERAGE COST PER MONTH

                A.            July 1, 1988 - Dec. 31, 1989                                                             $1,726 per month

                B.            Jan. 1, 1990 - Dec. 31, 1991                                                             $2,004 per month

                C.            Jan. 1, 1992 - Dec. 31, 1992                                                             $2,217 per month

                D.            Effective July 1, 1993, for application                                            $2,377 per month

                                register on or after Jan. 1, 1993

                E.            Jan. 1, 1994 - Dec. 31, 1994                                                             $2,513 per month

                F.            Jan. 1, 1995 - Dec. 31, 1995                                                             $2,592 per month

                G.            Jan. 1, 1996 - Dec. 31, 1996                                                             $2,738 per month

                H.            Jan. 1, 1997 - Dec. 31, 1997                                                             $2,889 per month

                I.             Jan. 1, 1998 - Dec 31, 1998                                                               $3,119 per month

                J.             Jan. 1, 1999 - Dec. 31, 1999                                                             $3,429 per month

                K.            Jan. 1, 2000 - Dec. 31, 2000                                                             $3,494 per month

                L.            Jan. 1, 2001 - Dec. 31, 2001                                                             $3,550 per month

                M.           Jan. 1, 2002 - Dec. 31, 2002                                                             $3,643 per month

                N.            Jan. 1, 2003 - Dec. 31, 2003                                                             $4,188 per month

                O.            Jan. 1, 2004 - Dec. 31, 2004                                                             $3,899 per month

                P.            Jan. 1, 2005 - Dec. 31, 2005                                                             $4,277 per month

                Q.            Jan. 1, 2006 - Dec. 31, 2006                                                             $4,541 per month

                R.            Jan. 1, 2007 - Dec. 31, 2007                                                             $4,551 per month

                S.             Jan. 1, 2008 - Dec. 31, 2008                                                             $4,821 per month

                T.            Jan. 1, 2009 - Dec. 31, 2009                                                             $5,037 per month

                U.            Jan. 1, 2010 - Dec. 31, 2010                                                             $5,269 per month

                V.            Jan. 1, 2011 - Dec. 31, 2011                                                             $5,774 per month

                W.           Jan. 1, 2012 - Dec. 31, 2012                                                             $6,015 per month

                X.            Jan. 1, 2013 - Dec. 31, 2013                                                             $6,291 per month

                Y.            Jan. 1, 2014 - Dec. 31, 2014                                                             $6,229 per month

                Z.            Jan. 1, 2015 - Dec. 31, 2015                                                             $6,659 per month

                AA.         Jan. 1, 2016 - Dec. 31, 2016                                                             $7,786 per month

                BB.         Jan. 1, 2017 - Dec. 31, 2017                                                             $7,485 per month

                CC.         Jan. 1, 2018 - Dec. 31, 2018                                                             $7,025 per month

                DD.         Jan. 1, 2019 - Dec. 31, 2019                                                             $7,285 per month

                EE.         Jan. 1, 2020 - Dec. 31, 2020                                                             $7,480 per month

                FF.          Jan. 1, 2021 - Dec. 31, 2021                                                             $7,590 per month

                GG.        Jan. 1, 2022 - Dec. 31, 2021                                                             $7,811 per month

                HH.        Jan. 1, 2023 - Dec. 31, 2023                                                             $8,275 per month

                II.            Jan. 1, 2024 -                                                                                        $8,919 per month

[8.200.510.13 NMAC - Rp, 8.200.510.13 NMAC, 7/1/2015; A/E, 1/1/2016; A/E, 3/1/2017; A/E, 8/30/2018; A/E, 4/11/2019; A, 7/30/2019; A/E, 8/11/2020; A, 12/15/2020; A/E, 4/1/2021; A, 9/1/2021; A/E, 4/1/2022; A, 8/9/2022; A/E, 4/1/2023; A/E, 4/1/2024; A, 8/1/2024]

 

8.200.510.15        EXCESS HOME EQUITY AMOUNT FOR LONG-TERM CARE SERVICES:

                A.            Jan. 2024               $713,000

                [(A)] B.  Jan. 2023               $688,000

                [(B)] C.  Jan. 2022               $636,000

                [(C)] D.  Jan. 2021               $603,000

                [(D)] E.  Jan. 2020               $595,000

                [(E)] F.  Jan. 2019               $585,000

                [(F)] G.  Jan. 2018               $572,000

                [(G)] H. Oct. 2017              $560,000

                [(H)] I.   Jan. 2017               $840,000

                [(I)] J.    Jan. 2016               $828,000

                [(J)] K.  Jan. 2015               $828,000

                [(K)] L. Jan. 2014               $814,000

                [(L)] M. Jan. 2013               $802,000

                [(M)] N. Jan. 2012               $786,000

                [(N)] O. Jan. 2011               $758,000

                [(O)] P.  Jan. 2010               $750,000

[8.200.510.15 NMAC - Rp, 8.200.510.15 NMAC, 7/1/2015; A/E, 1/1/2016; A/E, 3/1/2017; A, 3/1/18; A/E, 8/30/2018; A/E, 4/11/2019; A, 7/30/2019; A/E, 8/11/2020; A, 12/15/2020; A/E, 4/1/2021; A, 9/1/2021; A/E, 4/1/2022; A, 8/9/2022; A/E, 4/1/2023; A/E, 4/1/2024; A, 8/1/2024]