Supplements to NMAC Program Rules

Supplements to MAD NMAC Program Rules - 2020

Supplement Numbers	Policy Topic	Date
Special COVID -19 Supplement #1	Fingerprinting Guidance	April 2, 2020
Special COVID -19 Supplement #2	Medicaid Coverage of COVID-19 Testing for All Uninsured	April 2, 2020
Special COVID -19 Supplement #3	Guidance for New Mexico Medicaid Providers	April 6, 2020
Special COVID -19 Supplement #4	Families First Coronavirus Response Act (FFCRA) Coverage of COVID-19 Testing for Uninsured Patients Application form English Application form Spanish	May 6, 2020
20-01	New Mexico Health Insurance Prior Authorization	January 15, 2020
20-02	Senate Bill 246 Health Care Quality Surcharge (HCQS) Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)	May 21, 2020

Supplements to MAD NMAC Program Rules - 2019

Supplement Numbers	Policy Topic	Date
19-01	Reimbursement for Neurological and Neurosurgical Consultations Provided through ACCESS Program	January 3, 2019
19-02	Birthing Options Program-Billing Procedures and Reimbursement	June 21, 2019
19-03	BH Supplement & BH Manual - Comments and Responses	January 22, 2019
19-04	BH Supplement Behavioral Health Policy and Billing Manual Behavorial Health Policy and Billing Manual - Appendices Supplement 19-04 Addendum 1	January 22, 2019
19-05	Revised MAD 303 Fee for Service Prior Approvals Request Form	March 19, 2019
19-06	Billing for Annual Physical Health Examinations for Adults Applying for or Receiving Home and Community-Based Services through one of the following Waiver Programs: Developmental Disabilities (DD); Medically Fragile (MF); or Mi Via	March 30, 2019
19-07	Autism Spectrum Disorder Services – Prohibition on Age and Dollar Limits Effective June 15, 2019	June 15, 2019
19-08	Medically Fragile Waiver Fee Schedule	July 19, 2019
19-09	Medicaid Billing for Long-Acting Reversible Contraception (LARC) Products Provided in an Inpatient Setting	August 13, 2019
19-10	Chronic Care Management Services and Transitional Care	August 16,, 2019
19-11	Medicaid Drug Utilization Review (DUR) Provisions of the Support ACT	October 02, 2019

Supplements to MAD NMAC Program Rules - 2018

Supplement Numbers	Policy Topic	Date
18-02	Co-payment Change Resulting from the Behavioral Health Parity Analysis for Recipients in the Children's Health Insurance Program (CHIP) and Working Disabled Individuals (WDI)	March 6, 2018
18-03	Developmental Disabilities Waiver Fee Schedule	June 11, 2018
18-04	Notice of New Hepatitis C Virus (HCV) Treatment Requirements for Fee-for-Service (FFS) Medicaid Recipients	April 17, 2018
18-05	Critical Incident Reporting I. Critical Incident Reporting Form II. Critical Incident Reporting Protocol	May 1, 2018
18-08	Developmental Disabilities Waiver Fee Schedule	December 19, 2018
18-10	Billing for Annual Physical Health Examinations for Adults Applying for or Receiving Home and Community-Based Services through one of the following Waiver Programs: Developmental Disabilities (DD); Medically Fragile (MF); or Mi Via	December 6, 2018
18-12	Revised Nursing Facility Level of Care (NF LOC) Criteria and Instructions Effective January 1, 2019	January 1, 2019
18-13	Applied Behavior Analysis Prior Authorization (Stage 3) Submission for FFS Population	December 5, 2018

Supplements to MAD NMAC Program Rules - 2017

Supplement Numbers	Policy Topic	Date
17-01	Behavioral Health Respite Services - Effective 1/1/2017	January 20,2017
17-02	Notice of Proposed Medicaid Co-Payment Requirements for Medicaid Recipients	February 8, 2017
17-03	MAD 616 Fee for Service Out-of-State Prior Authorization	March 16, 2017
17-04	Changes to HCPCS and CPT Codes for Drug Testing for March	March 28, 2017
17-05	Qualis Health Provider Portal (QHPP) Requirement for Level of Care Requests and Prior Authorization Requests	June 29, 2017
17-06	Comprehensive Community Support Services (CCSS) I. Revised Service Definition II. Provider Requirements	June 23, 2017
17-07	Requirements for Reporting Attending, Ordering, Referring, and Rendering Providers on Claims	September 11,2017
17-08	Requirements for Reporting Ordering, Referring, and Rendering Providers on Claims	September 11, 2017
17-09	Requirements for Reporting Rendering, Ordering, and Referring Providers on Claims	September 11, 2017
17-10	Licensed Birth Centers	October 26, 2017
17-11	Early Periodic Screening, Diagnostic, and Treatment (EPSDT)Screening Services	November 15, 2017

Supplements to MAD NMAC Program Rules - 2016

Supplement Numbers

Policy Topic

Date

16-01

Notice of Proposed Reductions to the Medicaid Fee Schedule and Other Medicaid Payment Reductions

April 29, 2016

16-03

Notice of Final Reductions to the Medicaid Fee Schedule and Other Medicaid Payment Reductions - Effective July 1, 2016

June 29,2016

16-04

Revised MAD 303 Fee for Service Prior Approval Request Form

December 1, 2016

16-05

Changes to MAD 307 Denial of Claims Emergency Medical Services for Aliens (EMSA) Form

July 18, 2016

16-06

Changes to MAD 378 ICF/IID and Disabilities Home and Community Based Services Waiver Long Term Care Medical Assessment Abstract Form

July 18, 2016

16-07

Notice of Final Reductions to the Medicaid Fee Schedule -Effective August 1, 2016

July 22, 2016

16-08

Change to ABA Stage 1 Comprehensive Diagnostic Evaluation/Targeted Evaluation Requirements:

ABA Stage 2 and 3 Behavior Analyst Requirements

Specialty Care Practitioners

Certification of Behavior Technicians

September 23, 2016

16-09

Billing for Long Acting Reversible Contraception Products

September 16, 2016

16-10

Naloxone Kit Reimbursement for FFS Pharmacy Providers
Medicaid Coverage of Insect Repellents
Correct Way to Bill for Drugs Purchased at 340B Prices
Identifying Prescribing Providers
Pharmacy Dispensing Fees
Discontinued Funding of Non-Prescribed Emergency Contraception

September 23, 2016

16-11

Billing for Medication Monitoring by RNs
Group Therapy – Same Day Billing
Clarification on Prolonged Service
Assertive Community Treatment (ACT) Updates
The Use of Provisional Diagnoses for the “Treat First” Clinical Model

December 1, 2016

16-12

Reminder of Final Reductions to the Medicaid Fee Schedule – Effective January 1, 2017

December 13, 2016

16-13

Billing and Payments to Federally Qualified Health Centers (FQHC), Rural Health Clinics (RHC), Hospital Based Rural Health Clinics (HB-RHC) and Indian Health Service (IHS) FQHCs

January 6, 2017

16-14

Rescinding Behavioral Health Fee Schedule Reductions that were to be effective on January 1, 2017

December 22, 2016

Supplements to MAD NMAC Program Rules - 2015

Supplement Numbers	Policy Topic	Date
15-01	Specialized Behavior Health Services Billing Instructions	January 23, 2015
15-02	Medicaid Utilization Review & Third-Party Assessor Eff. 03/01/2015	February 9, 2015
15-03	Supplement on Multiple Topics, including ICD-10, Billing Using Paper Claims, etc.	May 13, 2015
15-04	Extension of Enhanced Payments for Primary Care Provider Services in 2015 and Beyond Primary Care Increase Self-Attestation Form – January 1, 2015	June 4, 2015
15-07	Short Term Medicaid for Incarcerated Individuals (STMII)	August 3, 2015
15-08	Changes to HCPCS & CPT Codes for Drug Testing 2016	December 29, 2015

Providers