1. A. The department shall provide for a statewide, managed care system to provide cost-efficient, preventive, primary and acute care for medicaid recipients by July 1, 1995.

2. B. The managed care system shall ensure:

   1. (1) access to medically necessary services, particularly for medicaid recipients with chronic health problems;
   2. (2) to the extent practicable, maintenance of the rural primary care delivery infrastructure;
   3. (3) that the department's approach is consistent with national and state health care reform principles; and
   4. (4) to the maximum extent possible, that medicaid-eligible individuals are not identified as such except as necessary for billing purposes.
3. C. The department may exclude nursing homes, intermediate care facilities for individuals with developmental or intellectual disabilities, medicaid in-home and community-based waiver services and residential and community-based mental health services for children with serious emotional disorders from the provisions of this section.

History: Laws 1994, ch. 62, § 22; 2023, ch. 113, § 4.

ANNOTATIONS

Cross references. — For Money Follows the Person in New Mexico Act, see 27-15-1 NMSA 1978.

The 2023 amendment, effective June 16, 2023, updated a term relating to developmental and intellectual disabilities; and in Subsection C, deleted "mentally retarded" and added "individuals with developmental or intellectual disabilities".

Subsection B of Section 27-1-16 does not apply to New Mexico’s managed health care system or managed care organizations. Starko, Inc. v. N.M. Human Servs. Dep’t, 2014-NMSC-033, rev'g 2012-NMCA-053, 276 P.3d 252.