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Centennial Care Letters of Direction

Inactive – LOD #1 – Guidance for CHV Program Implementation – Repealed and Replaced by LOD #1-1

LOD #1-1 Repeal and Replace CHV Program Implementation, Statewide

LOD #2 – Community Intervener I and II

Inactive – LOD #3 – Tracking Measure Reporting Requirements- Repealed and replaced by LOD #16

Inactive – LOD #4 – Nursing Facility Level of Care extensions- Sunset 6/30/2019

Inactive-LOD #5 – Implementation of the Annual Consumer, Family-Caregiver and Youth Satisfaction Project Survey – Repealed and Replaced by LOD #5-1

LOD #5-1 – Implementation of the Annual Consumer, Family-Caregiver and Youth Satisfaction Project (C/F/YSP) Survey

Inactive – LOD #6 – Compilation of NF LOC Criteria and Instructions eff. 1/1/2019 – Sunset on inclusion in the Managed Care Policy Manual eff. 10/1/2020

Inactive – LOD #7 – Directed Payment to UNM Medical Group- Repealed and replaced by LOD #9

Inactive – LOD #8 – Valle Del Sol Payment of Adult Psycho-Social Rehab Services-Sunset 6/30/2019

Inactive – LOD #9 – Directed Payment to UNM Medial Group- Repealed and Replaced by LOD #9-1

Inactive – LOD #9-1- UNM Medical Group and UNM Hospital Professional Group Directed Payment Repeal & Replace LOD #9| PHE ended: LOD sunset on May 11, 2023

Inactive – LOD #9-2 – UNM Medical Group and UNM Hospital Professional Group Directed Payment – Repealed and replaced by LOD #9-3

Inactive – LOD #9-3 – UNM Medical Group and UNM Hospital Professional Group Directed Payment-Repealed and Replaced by LOD #9-4

LOD #9-4 UNM Medical Group and UNM Hospital Professional Group Directed Payment

Inactive – LOD #10 – CY19 Telemedicine DSIPT- Repealed and replaced by LOD #11

Inactive – LOD #11 – CY19 Telemedicine DSIPT- Sunset upon completion of the CY19 DSIPT Reporting Period

Inactive-LOD #11-1 – Reporting Requirements for Prior Authorization and Cost-Sharing|PHE ended: LOD sunset on May 11, 2023

LOD #12 – Medicaid Provider Payment Rates

Inactive – LOD #13 – Hospital Payment Rate Increase- Repealed and replaced by LOD #14

Inactive – LOD #14 – Hospital Payment Rate Increase- Repealed and replaced by LOD #20

Inactive – LOD #15 – Payment to Raton Nursing & Rehabilitation center- Sunset 11/30/2019

Inactive – LOD #16 – Tracking Measure Reporting Requirements- Repealed and replaced by LOD #22

Inactive – LOD #17 – SUPPORT Act Requirements- Sunset on inclusion in Contract Amendment #2

Inactive-LOD #18 – Use of Electronic Visit Verification for EPSDT Personal Care Services- Sunset upon inclusion in Contract Amendment 4

LOD #19 – Medicaid Provider Payment Rates

LOD #20 – Hospital Payment Rates Effective July 1, 2019 Repeal LOD #14

Inactive – LOD #21 – CBSQ and CBMA-Sunset on inclusion in the Managed Care Policy Manual eff. 10/1/2020

Inactive – LOD #22 – Tracking Measure Reporting Requirements- Repealed and replaced by LOD #33

Inactive- LOD #23 – Delivery System Improvement Performance Targets (DSIPTs)- Sunset on inclusion in Contract Amendment #2

Inactive- LOD #24 – 2020 Performance Measures and Targets- Sunset on inclusion in Contract Amendment #2

Inactive- LOD #25 – Payment Rate Increases Effective January 1, 2020- Repealed and Replaced by LOD #28

Inactive- LOD #26 – Quarterly Care Coordination Performance Standards- Sunset on inclusion in Contract Amendment #2

Inactive-LOD #27 – CY 19 Performance Measures-Sunset with the next iteration of the Medicaid Managed Care Services Agreement

Inactive-LOD #28 – Payment Rate Increases Effective January 1, 2020 Repealed and Replaced by LOD 28-1

Inactive-LOD #28-1 – Payment Rate Increases Effective January 1, 2020-Repealed and Replaced by LOD #28-2

LOD #28-2 – Payment Rate Increases Effective January 1, 2020

Inactive-LOD #29 – ABP Corrections- Sunset on inclusion in Contract Amendment #2

Inactive-LOD #30 – COVID-19 Guidance for CC 2.0 MCOs- Repealed and Replaced by LOD #31

Inactive-LOD #31 – COVID-19 Guidance for CC 2.0 MCOs- Repealed and Replaced by the “Special COVID-19 LODs” below

LOD #32 – Health Care Quality Surcharge (HCQS) created by Senate Bill 246 (SB246)

Inactive-LOD #33 – Tracking Measure Reporting Requirements Repeal and Replaced LOD #22

Inactive – LOD #33-1- Tracking Measure Reporting Requirements – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD #34 – Tobacco Cessation Coverage for all MAP Recipients-Sunset upon inclusion in the Medicaid Managed Care Services Agreement

Inactive-LOD #35 – UNM Hospital Directed Payment -Repealed and Replaced by LOD #35-1

Inactive-LOD #35-1 -UNM Hospital Directed Payment-Repealed and Replaced by LOD #35-2

Inactive-LOD #35-2 -UNM Hospital Directed Payment-Repealed and Replaced by LOD #35-3

LOD #35-3 – UNM Hospital Directed Payment

Inactive-LOD #36 – Hospital Access Program (HAP) Directed Payment-Repealed and Replaced by LOD #36-1

Inactive-LOD #36-1-Hospital Access Program (HAP) Directed Payment-Repealed and Replaced by LOD #36-2

Inactive-LOD #36-2 – Hospital Access Program (HAP) Directed Payment -Repealed and Replaced by LOD #36-3

LOD #36-3 Hospital Value Based Program (HVBP) Directed Payment

LOD #37 – Nursing Facility Value Based Purchasing (NF VBP)

Inactive-LOD #38 – Change Contact Requirements for DTE Members requiring a CNA-Sunset upon inclusion in the Medicaid Managed Care Services Agreement 

Inactive-LOD #39 – Care Link New Mexico Health Homes-Sunset on 12/31/2020

Inactive-LOD #40 – Medication Assisted Treatment (MAT) Medications: Narcan and Naloxone- Repealed and Replaced by LOD #40-1

LOD #40-1 – Medication Assisted Treatment (MAT) Medications; Narcan and Naloxone

LOD #41 – MCO Program Integrity Requirements

LOD #42 – Transition of Payment from Medicaid to Medicare for OTP Services

Inactive-LOD #43 – Community Benefit Reconciliation-Sunset upon inclusion in Medicaid Managed Care Services Agreement

LOD #44 – ABA Payment Rates Increases Effective October 1, 2019

Inactive-LOD #45 – Adult Accredited Residential Treatment Centers-Repealed and Replaced by LOD #45-1

Inactive-LOD #45-1 – Implementation of Adult Accredited Residential Treatment Center Services-Sunset with the next iteration of the Behavioral Health Policy and Billing Manual

Inactive-LOD #46 – Medical Residency Pilot Program- Sunset

LOD #47 – HCQS Per Diem and MBI increase for SFY 2021

Inactive-LOD #48 – Reconciliation of claims for the ABA Payment Rates Increases Effective October 1, 2019-Sunset upon completion of claim reimbursement

Inactive-LOD #49 – MCO Payment Recoupment from Providers-Sunset upon inclusion in the Systems Manual

LOD #50 – Naturopathic Doctors: Participation in the NM Medicaid Program

LOD #51 – New 1915 (c) Home and Community-Based Services Program – Supports Waiver

LOD #52 – MCO Systems Configurations for BH Claims from FQHC Satellite Locations

Inactive – LOD #53 – Managed Care Subrogation Recoveries – Sunset upon inclusion in Contract Amendment 6

Inactive – LOD #54 – BH DSIPT – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD #55 – Provider Changes for Minimum Wage Adjustment-Repealed and Replaced by LOD #55-1

Inactive-LOD #55-1 – Provider Changes for Minimum Wage Adjustment-Sunset on 1/20/2022 upon approval of LOD #75

Inactive-LOD #56 – CareLink NM Health Homes -Sunset December 31,2021

Inactive – LOD #57 – Gross Receipts Tax (GRT) – Sunset upon inclusion in Contract Amendment 6

Inactive – LOD #58 – CY 20 Performance Measures – Sunset upon inclusion in Contract Amendment

Inactive – LOD #59 – Non-Clinical PIPs Revision – Sunset upon inclusion in Contract Amendment 8

LOD #60 – NDC Requirement for Drug Rebate Collection and 340B Claim Billing

Inactive – LOD #61 – Change Contract Requirements for Full Delegation Model Members – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD #62 – Crisis Triage Centers- Sunset upon inclusion in the Behavioral Health Policy and Billing Manual

Inactive – LOD #63 – Grievances Appeals Systems – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD #64 – Expedited Provider Set Up and Allowances of Treat First Service Delivery-Sunset on 12/31/2021

LOD #65 – HCQS Per Diem and MBI increase for SFY 2022

Inactive – LOD #66 – Health Risk Assessment for Transitioning Members – Sunset upon inclusion in Contract Amendment 6

LOD #67 – EOB Exception for Behavioral Health Services and Providers

Inactive-LOD #68 – Trauma Hospitals Directed Payment-Repealed and Replaced by LOD #68-1

Inactive – LOD #68-1 – Trauma Hospital Directed Payment-Repeal and Replaced by #68-2

Inactive – LOD #68-2 – Trauma Hospital Directed Payment – Repealed and Replaced by LOD # 68-3

LOD #68-3 – Trauma Hospitals Directed Payment

Inactive – LOD #69 – MCO Requirements for Children in State Custody (CISCs)-Repealed and Replaced by LOD #69-1

LOD #69-1 – MCO Requirements for Children in State Custody (CISCs)-Repealed and Replaced by LOD #69-1

Inactive – LOD #70 – I.H.S. & Tribal 638 Outpatient Pharmacy Reimbursement Change

Inactive – LOD #70-1 – I.H.S. & Tribal 638 Outpatient Pharmacy Annual Reimbursement Rates Changes – Repealed and Replaced by LOD #70-2

LOD #70-2 – I.H.S. & Tribal 638 Outpatient Pharmacy Annual Reimbursement Rate Changes

Inactive-LOD #71 – Bernalillo Academy Reimbursement for Multiple Assessments-Sunset on 12/31/2021

Inactive – LOD #72 – MY 2020 CAHPS 5.0H Revised State Supplemental Questions – Sunset upon inclusion in Contract Amendment 6

Inactive – LOD #73 – Performance Measures Reporting Requirements – Sunset upon inclusion in Contract Amendment 6

Inactive – LOD #74 – Revision to Comprehensive Care Plan Requirements – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD #75 – Minimum Wage Adjustment

LOD #75-1 Minimum Wage Adjustments Repeal and Replace #75

Inactive – LOD #76 – CAHPS 5.0H AHRQ Reporting and Revised Supplemental Questions – Sunset upon inclusion in Contract Amendment 6

Inactive – LOD #77 – Revision to PCP and Pharmacy Lock-In Requirements – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD #78 – Pharmaceutical Service Reimbursement Parity-Sunset upon inclusion in the Managed Care Policy Manual

LOD #78-1 – Pharmaceutical Service Reimbursement Parity

Inactive-LOD #79 – 15 % Temporary Economic Recovery Payments for HCBS Services-Repealed and Replaced by LOD #79-1

LOD #79-1 10% and 5% Temporary Economic Recovery Payments for HCBS Services

LOD #80 – SBHC LARC Inventory Pilot Project

Inactive – LOD #81 – Critical Incident Performance Measures – Sunset upon inclusion in Contract Amendment 6

Inactive – LOD #82 – MCO Requirements for NMHIX aka beWellnm Coverage – Sunset upon inclusion in Contract Amendment 6

Inactive-LOD# 83 – HCQS Per Diem and MBI increase for SFY 2023-Repealed and Replaced by LOD #83-1

LOD #83-1 Health Care Quality Surcharge (HCQS) SFY2024

LOD #84 – Paid Sick Leave

Inactive – LOD #85 – Community Benefit Audits

Inactive-LOD #86 – Out of-state Treatment Foster Care-Repealed and Replaced by #86-1

LOD #86-1 – Out of-state Treatment Foster Care Repeal and Replace #86

Inactive – LOD #87- MCO Quarterly Pharmacy and Therapeutics Committee Meeting Updates – Sunset upon inclusion in Contract Amendment 6

LOD #88 – Billing for Specialized BH Services by FQHCs

LOD #89 – Suspension of Prior Authorization Requirements for Skilled Nursing, Long-Term Care, and Home Health Facilities

Inactive – LOD #90 – New BH DSIPT – Sunset upon inclusion in Contract Amendment 8

LOD #91 – Supervisory Certification and Rostering

LOD #92 – Ventilator Services

LOD #93 – Community Benefit Environmental Modifications and Community Transition Services

Inactive – LOD #94 MCO PHE Unwinding Outreach Report – Repealed and Replaced by LOD #94-1

LOD #94-1 MCO Outreach Efforts

Inactive – LOD #95 MY2023 CAHPS Supplemental Questions – Sunset upon inclusion in Contract Amendment 8

LOD # 96 – Comprehensive Well Child Check Ups for Children in State Custody Within 30 Days

LOD #97 – Human Donor Milk Billing and Guidance in an Inpatient Hospital

LOD #98 – Expiration of the PHE

Inactive – LOD #99 – NM High-Fidelity Wraparound Program

LOD #99-1 – NM High-Fidelity Wraparound Program

LOD #100 – Coordination of Treatment of Foster Care (TFC) Placement for Children in State Custody CISC

LOD #101 Prenatal Genetic Screening

LOD #102 NEMT Referrals for Outside of the Home Community Guidance

LOD #103 State Fiscal Year 2024 Payment Rate Increases

LOD #104 Public Health Order Issued 09/15/2023

LOD #105 Care Coordination for Comprehensive Addiction and Recovery Act (CARA) Infants

Inactive – LOD #106 Operational Letter of Direction – Sunset upon inclusion in Contract Amendment 8

Inactive – LOD #107 BH standards for Crisis Now and 988, Certified Community Behavioral Health Centers (CBHCs), and Appointments – Sunset upon inclusion in Contract Amendment 8

LOD #108 Legally Responsible Individuals as Caregivers

LOD #109 Program Integrity Requirements

LOD #110 Non-Emergency Transportation Network Companies

LOD #111 Nursing Facility Short Term Stays

LOD #112 Transcranial Magnetic Stimulation (TMS) Services

LOD #113 Behavioral Health Evidence-based Practices 

Special COVID-19 Letters of Direction

Inactive-Special COVID-19 LOD #1 – Medicaid Expedited Claims Payments |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #2 – COVID-19 Guidance for Hospitals using Alternate Care Sites|PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #3 – Provider Network and Out-of-Network Requirements |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #4 – COVID-19 MCO Guidance for Fair Hearings |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #5 – Member and Provider Communication Protocols |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #6 – Care Coordination In-Home & Services Community Benefits – Repealed and Replaced by Special COVID-19 LOD #6-1

Inactive-Special COVID-19 LOD #6-1 – In-Home Services and Community Benefits|PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #7 – Special Requirements for Pharmacy and Waiver of Signature|PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #8 – COVID-19 Testing and Treatment Services and Codes – Repealed and Replaced by Special COVID-19 LOD #8-1

Inactive-Special COVID-19 LOD #8-1 – COVID-19 Testing and Treatment Services and Codes – Repealed and Replaced by Special COVID-19 LOD #8-2

Inactive-Special COVID-19 LOD# 8-2 – COVID-19 Testing and Treatment Services and Codes – Repealed and Replaced by Special COVID-19 LOD #8-3

Special COVID-19 LOD #8-3 – Testing and Treatment Services and Codes

Inactive-Special COVID-19 LOD #9 – COVID-19 Special Requirement for Prior Authorization and Cost-Sharing – Repealed and Replaced by Special COVID-19 LOD #9-1

Inactive-Special COVID-19 LOD #9-1 – COVID-19 Special Requirement for Prior Authorization and Cost-Sharing – Requirement for Prior Authorization and Cost-Sharing|PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #10 – 2020 Hospital Inpatient Payment Rate Increases- Repealed and Replaced by Special COVID-19 LOD #10-1

Inactive-Special COVID-19 LOD #10-1 -COVID-19 DRG & ICU Hospital Inpatient Payment Rate Increases – on September 30, 2020

Inactive- Special COVID-19 LOD #11 – Reporting Requirements- Repealed and Replaced by Special COVID-19 LOD #11-1

Inactive-Special COVID-19 LOD #11-1 – Reporting Requirements- Repeal and Replace Special COVID-19 LOD #11 |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #12 – Community Benefit Appendix K – Repealed and Replaced by Special COVID-19 LOD #12-1

Inactive-Special COVID-19 LOD #12-1- Community Benefit Appendix K|PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #13 – Telehealth Services during the COVID-19 Emergency – Repealed and Replaced by Special COVID-19 LOD #13-1

Special COVID-19 LOD #13-1 – Telehealth Services during the COVID-19 Emergency

Inactive-Special COVID-19 LOD #14 – COVID-19 Rate Increase for ALFs |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #15 – Nursing Facility Rate Increase-Sunset upon inclusion in Contract Amendment #4

Inactive-Special COVID-19 LOD #16 – Non-DRG Hospital Inpatient Payment Rate Increase -Repealed and Replaced by Special COVID LOD#16-1

Inactive-Special COVID-19 LOD #16-1 – Non-DRG Hospital Inpatient Payment Rate Increase|PHE ended: LOD sunset on May 11, 2023 

Inactive-Special COVID-19 LOD #17 – COVID-19 Guidance: NEMT and State Isolation Sites |PHE ended on May 11, 2023

Inactive-Special COVID-19 LOD #18 – Billing and Reimbursement for Testing and Services Rendered Offsite for FQHCs, IHS and Tribal 638 Facilities, RHCs, and HBRHCs| PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #19 – NM DOH COVID-19 Claims – Waive Timely Filing – Repealed and Replaced by Special COVID LOD #19-1

Inactive-Special COVID-19 LOD #19-1 – COVID -19 Claims-Waive Timely Filing for All Medicaid enrolled Providers |PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #20 – Surveillance Testing | PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #21 – Provider Rate Increases and Claims Adjustments for dates of service April 1, 2020 – June 30, 2020| PHE ended: LOD sunset on May 11, 2023

Inactive-Special COVID-19 LOD #22 COVID-19 – Vaccine Guidance-Sunset upon inclusion in Contract Amendment #4

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