Services must be purchased within the state of NM, unless the need to purchase services elsewhere is documented and approved by the CMS medical director.

1. A. Services may be purchased outside the state of NM when:

   (1) the specific service is not available in NM; or

   (2) an eligible client is temporarily out of state and does not qualify for medical assistance in the state of temporary residence, and the health of the client would be endangered if services were postponed until return to NM or by travel to NM; or

   (3) excessive time, distance, and expense would be involved in order to obtain outpatient services in NM. Inpatient services are eligible out of state if urgent or emergency hospitalization is needed when distance is excessive or in-state tertiary centers are full.

2. B. Services may not, under any circumstances, be purchased out of state without approval of the medical director or designee.
3. C. Out-of-state providers are subject to the same fee schedule, time limitations, standards, and requirements, including operating under a provider agreement, as in-state providers.

[7.30.3.15 NMAC - Rp, 7 NMAC 30.3.13, 10/30/12]