TITLE 8 SOCIAL SERVICES

CHAPTER 215 MEDICAID ELIGIBILITY - SUPPLEMENTAL SECURITY INCOME (SSI) METHODOLOGY

PART 600 BENEFIT DESCRIPTION

8.215.600.1 ISSUING AGENCY: New Mexico Health Care Authority.

[8.215.600.1 NMAC - Rp, 8.215.600.1 NMAC, 1/1/2019; A,7/1/2024]

8.215.600.2 SCOPE: The rule applies to the general public.

[8.215.600.2 NMAC - Rp, 8.215.600.2 NMAC, 1/1/2019]

8.215.600.3 STATUTORY AUTHORITY: The New Mexico medicaid program is administered pursuant to regulations promulgated by the federal department of health and human services under Title XIX of the Social Security Act, as amended and by the state health care authority pursuant to state statute. See Section 27-2-12 et seq. NMSA 1978 (Repl. Pamp. 1991). Section 9-8-1 et seq. NMSA 1978 establishes the health care authority (HCA) as a single, unified department to administer laws and exercise functions relating to health care facility licensure and health care purchasing and regulation.

[8.215.600.3 NMAC - Rp, 8.215.600.3 NMAC, 1/1/2019; A, 7/1/2024]

8.215.600.4 DURATION: Permanent.

[8.215.600.4 NMAC - Rp, 8.215.600.4 NMAC, 1/1/2019]

8.215.600.5 EFFECTIVE DATE: January 1, 2019, or upon a later approval date by the federal centers for medicare and medicaid services (CMS), unless a later date is cited at the end of the section.

[8.215.600.5 NMAC - Rp, 8.215.600.5 NMAC, 1/1/2019]

8.215.600.6 OBJECTIVE: The objective of these regulations is to provide eligibility policy and procedures for the medicaid program.

[8.215.600.6 NMAC - Rp, 8.215.600.6 NMAC, 1/1/2019]

8.215.600.7 DEFINITIONS: [RESERVED]

8.215.600.8 [RESERVED]

8.215.600.9 GENERAL BENEFIT COVERAGE: Medicaid coverage for services based on determinations made using the SSI methodology varies based on the category of eligibility. For applicants/recipients who are eligible for SSI, full medicaid coverage for services is available. If applicants/recipients are eligible for medicare coverage, medicaid covers medicare premium amounts.

[8.215.600.9 NMAC - Rp, 8.215.600.9 NMAC, 1/1/2019]

8.215.600.10 SSI RETROACTIVE BENEFIT COVERAGE: Retroactive medicaid coverage is provided in accordance with 8.200.400.14 NMAC.

[8.215.600.10 NMAC - Rp, 8.215.600.10 NMAC, 1/1/2019]

8.215.600.11 CHANGES IN ELIGIBILITY: A case is closed, with provision of advance notice when the recipient becomes ineligible. If a recipient dies, the case is closed the following month.

[8.215.600.11 NMAC - Rp, 8.215.600.11 NMAC, 1/1/2019]

HISTORY OF 8.215.600 NMAC:

Pre NMAC History: The material in this part was derived from that previously filed with the State Records Center.

MAD Rule 860, SSI Methodology for Computation of Countable Resources and Income, filed 3/7/1989.

MAD Rule 860, SSI Methodology for Computation of Countable Resources and Income, filed 3/21/1990.

MAD Rule 860, SSI Methodology for Computation of Countable Resources and Income, filed 4/24/1991.

MAD Rule 860, SSI Methodology for Computation of Countable Resources and Income, filed 6/19/1992.

MAD Rule 861, Resources - SSI Methodology for Computation of Countable Resources and Income, filed 3/18/1993.

MAD Rule 861, Resources - SSI Methodology for Computation of Countable Resources and Income, filed 12/29/1994.

MAD Rule 862, Income - SSI Methodology for Computation of Countable Resources and Income, filed 3/18/1993.

MAD Rule 864, Potential Income or Resources - SSI Methodology for Computation of Countable Resources and Income, filed 3/18/1993.

MAD Rule 866, Deeming Income, filed 11/16/1994.

History of Repealed Material:

MAD Rule 860, SSI Methodology for Computation of Countable Resources and Income, filed 6/19/1992 - Repealed effective 2/1/1995.

MAD Rule 861, Resources - SSI Methodology for Computation of Countable Resources and Income, filed 12/29/1994 - Repealed effective 2/1/1995.

MAD Rule 862, Income - SSI Methodology for Computation of Countable Resources and Income, filed 3/18/1993- Repealed effective 2/1/1995.

MAD Rule 864, Potential Income or Resources - SSI Methodology for Computation of Countable Resources and Income, filed 3/18/1993 - Repealed effective 2/1/1995.

MAD Rule 866, Deeming Income, filed 11/16/1994 - Repealed effective 2/1/1995.

8.215.600 NMAC - Benefit Description filed 9/3/2013 - Repealed effective 1/1/2019.