This plan amendment updates the Substance Abuse Intensive Outpatient Program (SAIOP) reimbursement rate.

This amendment is to add rural emergency hospital clinics as a Medicaid provider.

This amendment is to adjust the premium scale per 441 IAC 75.1(39)”b”. The maximum premium amount is based on the avg. state employee health insurance premium which is, for a single person, $958.50 effective January 1, 2024.

This amendment is relating to an executive reorganization which will rename the Human Services Department (HSD) as the Health Care Authority (HCA). As a new executive department, HCA will administer laws and exercise functions relating to health care purchasing, policy, and regulation for the State of New Mexico.

This amendment complies with the Consolidated Appropriations Act of 2022 and makes changes to the state plan so that health insurance companies cannot deny reclamation claims for the Agency not obtaining prior authorization for the item or service through the health insurance company and requiring health insurance companies to process reclamation claims within 60 days of receipt of such claims.

This amendment is to add Community Health Workers as Providers of Preventative Services to the Medicaid State Plan.

This amendment changes to state plan coverage of other licensed practitioner services to include licensed mental health therapists, licensed social service workers, licensed substance use disorder counselors, and licensed behavioral health coaches.

This amendment is to add Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) to the FQHC and RHC sections of its Medicaid State Plan to be in compliance with CAA 2023.