A. Consistent with the federal act, the department shall provide necessary hospital care for recipients of public assistance other than those eligible under the general assistance program authorized by Section 10 [27-2-7 NMSA 1978] of the Public Assistance Act. The rate of payment for in-patient hospital services shall be based either on the reasonable cost or the customary cost of such services, whichever is less. In determining reasonable cost under this section, the board shall adopt regulations establishing a formula consistent with the federal act. The department shall apply that formula to determine the amount to which each hospital is entitled as reimbursement for providing in-patient hospital services.
B. To receive reimbursement for providing in-patient hospital services, a hospital shall file annually with the department such information as the department may reasonably require to determine reasonable costs or the hospital's customary cost of in-patient hospital services.
C. Any hospital entitled to reimbursement for in-patient hospital services shall be entitled to a hearing, pursuant to regulations of the board consistent with applicable state law, if the hospital disagrees with the department's determination of the reimbursement the hospital is to receive.
History: 1953 Comp., § 13-17-12, enacted by Laws 1973, ch. 376, § 13.
Cross references. — For medical assistance programs generally, see 27-2-12 NMSA 1978.
Am. Jur. 2d, A.L.R. and C.J.S. references. — 79 Am. Jur. 2d Welfare Laws §§ 4, 32, 38 to 41, 87, 88, 105.
Medical or surgical services rendered to poor person in emergency, without express authority, liability of governmental agency for, 93 A.L.R. 900.
Nature of care contemplated by statute imposing general duty to care for indigent relatives, 92 A.L.R.2d 348.
Limitation on right of chiropractors and osteopathic physicians to participate in public medical welfare programs, 8 A.L.R.4th 1056.
81 C.J.S. Social Security and Public Welfare §§ 102, 122, 128, 133.
Structure New Mexico Statutes
Chapter 27 - Public Assistance
Article 2 - Public Assistance Act
Section 27-2-3 - Standard of need; income determination.
Section 27-2-4 - Eligibility requirements.
Section 27-2-6.1 - Supplemental postnatal assistance.
Section 27-2-7 - General assistance program; qualifications and payments.
Section 27-2-7.1 - Eligible person entitled to information.
Section 27-2-9 - Payment for hospital care.
Section 27-2-9.1 - Administration of shelter care supplement.
Section 27-2-10 - Food stamp program.
Section 27-2-11 - Scope of assistance programs.
Section 27-2-12 - Medical assistance programs.
Section 27-2-12.2 - Medical assistance program; eligibility of married individuals.
Section 27-2-12.6 - Medicaid payments; managed care.
Section 27-2-12.8 - Mammograms for medicaid recipients.
Section 27-2-12.9 - Medicaid; personal spending allowances; increases.
Section 27-2-12.10 - Clinical nurse specialists.
Section 27-2-12.11 - Prescription drug waiver program; purpose; eligibility.
Section 27-2-12.12 - Human services department; managed care contract credentialing provisions.
Section 27-2-12.13 - Medicaid reform; program changes.
Section 27-2-12.14 - Brain injury; services authorized.
Section 27-2-12.20 - Crisis triage center; medical assistance reimbursement.
Section 27-2-12.21 - Medical assistance; pharmacy benefits; prescription synchronization.
Section 27-2-12.24 - Medical assistance; plan of care; participation required.
Section 27-2-12.25 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 27-2-12.28 - Medical assistance; autism spectrum disorder.
Section 27-2-12.30 - Pharmacist prescriptive authority services; reimbursement parity.
Section 27-2-12.31 - Heart artery calcium scan coverage.
Section 27-2-13 - Conflict in federal and state laws.
Section 27-2-14 - Continuing effect of regulations and standards.
Section 27-2-15 - Cooperation with United States.
Section 27-2-16 - Compliance with federal law.
Section 27-2-17 - Custodian of funds.
Section 27-2-18 to 27-2-20 - Repealed.
Section 27-2-21 - Assistance not assignable.
Section 27-2-23 - Third party liability.
Section 27-2-24 - [Federal government entitled to share recovery.]
Section 27-2-25 - Funeral expenses.
Section 27-2-26 - Money received from other sources; duty and liability of funeral director.
Section 27-2-27 - Single state agency; powers and duties.
Section 27-2-28 - Liability for repayment of public assistance.
Section 27-2-29.1 - Compensation under contingent fee contracts; suspense fund created.
Section 27-2-30 - [Enforcement of support;] orders.
Section 27-2-31 - Judgments and proceeds.
Section 27-2-32 - Duty of agencies to cooperate.
Section 27-2-34 - Limitations of act.
Section 27-2-35 to 27-2-40 - Repealed.
Section 27-2-41 - Short title.
Section 27-2-42 - Legislative findings; purpose.
Section 27-2-43 - Definitions.
Section 27-2-44 - Indigent catastrophic illness hospital fund created.
Section 27-2-45 - Hospitals; claims for payment.