N.M. Code R. § 8.310.12.13

Prior Authorization and Utilization Review

Effective Nov 1, 2014State of New Mexico

IHS and tribal 638 facilities need not obtain prior authorization for services, but must continue to follow standards of care within its scope of practice and retain documentation in the eligible recipient’s physical and behavioral health record. MAD services are subject to utilization review for medical necessity and program compliance. Reviews may be performed before or after services are furnished.

[8.310.12.13 NMAC - N, 11/1/2014]

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