Disclaimer: Using the New Mexico Written Tribal Notification Guides

This portion of the website is reserved for tribal consultation, and Indian Health Service facility and 638 Tribal facility notifications.

Reminder – You have acknowledged that you are accessing this site because of your tribal responsibilities or responsibilities with an Indian Health Service or 638 Tribal Facility

Written Tribal Notification Letters – Comment Period Open – 2021

Written Tribal Notification Letter 21-01

• Draft Waiver Amendment Application
• Attachment A: Assessment of the Availability of Mental Health Services

Written Tribal Notification Letters – Comment Period Open – 2020

Written Tribal Notification Letter 20-33

• 8.281.400 NMAC, Medicaid Eligibility – Institutional Care (Categories 081, 083 and 084), Recipient Policies
• 8.290.400 NMAC, Medicaid Eligibility – Home and Community-Based Services Waiver (Categories 090, 091, 092, 093, 094, 095 AND 096), Recipient Policies

Written Tribal Notification Letter 20-32

• Draft Medically Fragile Waiver Application 

Written Tribal Notification Letter 20-31

• Proposed SPA 21-0001 IHS & Tribal 638 Pharmacy Payment

Written Tribal Notification Letter 20-28

• Draft Developmental Disabilities Waiver Application 

Written Tribal Notification Letter 20-27

• Proposed SPA 20-0022 FQHC Designation

Written Tribal Notification Letter 20-26

• Mi Via 1915(c) Home and Community Based Services Waiver – Removal of Native American Healers as a Specialized Service

Written Tribal Notification Letter 20-25

• Proposed SPA 20-0020 Air Ambulance Rates

Written Tribal Notification Letter 20-24

• 8.280.400 NMAC, Medicaid Eligibility – Program of All Inclusive Care for the Elderly (PACE), Recipient Policies

Written Tribal Notification Letter 20-23

• Proposed SPA 20-0019 Graduate Medical Education (GME) Program

Written Tribal Notification Letter 20-22

• Proposed SPA 20-0018 Nursing Facility (NF) Payment

Written Tribal Notification Letter 20-21

• Proposed SPA 20-0017 Diagnosis Related Group (DRG) Payment

Written Tribal Notification Letter 20-20

• Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services

Written Tribal Notification Letter 20-19

• 8.326.10 NMAC, Brain Injury Services Fund Program

Written Tribal Notification Letter 20-18

• Long Term Care Services – Waivers, Supports Waiver

Written Tribal Notification Letter 20-17

• Proposed SPA 20-0016 State Plan Pages
• Proposed SPA 20-0016 MACPro Pages

Written Tribal Notification Letter 20-16

Written Tribal Notification Letter 20-15

Written Tribal Notification Letter 20-14

Written Tribal Notification Letter 20-12

Written Tribal Notification Letter 20-13

• 8.215.500 NMAC, Medicaid Eligibility SSI Methodology, Income and Resource Standards
• 8.240.500 NMAC, Medicaid Eligibility – Qualified Medicare Beneficiaries (QMB) (Category 040), Income and Resource Standards
• 8.242.500 NMAC, Medical Assistance Program Eligibility – Qualified Disabled Individuals, Income and Resource Standards
• 8.245.500 NMAC, Medicaid Eligibility – Specified Low Income Medicare Beneficiaries (SLIMB) (Category 045), Income and Resource Standards
• 8.250.500 NMAC, Medical Assistance Program Eligibility – Qualified Disabled Individuals Whose Income Exceeds QMB and SLIMB, Income and Resource Standards
• Regulatory Impact Form

 

Written Tribal Notification Letter 20-09

• 8.200.510 NMAC, Medicaid Eligibility – General Recipient Policies, Resource Standards
• 8.200.520 NMAC, Medicaid Eligibility – General Recipient Rules, Income Standards

 

• Section 2 Provider Network
• Section 4 Care Coordination
• Section 5 Transitions of Care
• Section 6 Nursing Facilities
• Section 7 Community Benefits
• Section 8 Agency-Based Community Benefit
• Section 9 Self-Directed Community Benefit
• Section 11 Marketing
• Section 13 Alternative Benefit Package
• Section 14 School-Based Health Centers
• Section 18 Quality
• Section 20 Pharmacy

Written Tribal Notification Letter 20-11​

Written Tribal Notification Letter 20-10​

Written Tribal Notification Letter 20-08

• Proposed SPA 20-0001 Health Homes (SUD)

Written Tribal Notification Letter 20-07

• Draft NM019.6.02  Developmental Disabilities Waiver Amendment Application
• Proposed Fee Schedule

Written Tribal Notification Letter 20-06 (reissue)

Written Tribal Notification Letter 20-06

Written Tribal Notification Letter 20-04

• 8.291.430 NMAC, Medicaid Eligibility – Affordable Care, Financial Responsibility Requirements
• Regulatory Impact Form

Written Tribal Notification Letter 20-03

• 8.285.400 NMAC-Medical Assistance Program Eligibility-Emergency Medical Services for Aliens, Recipient Requirements
• 8.285.600 NMAC-Medicaid Eligibility-Emergency Medical Services for Aliens (Category 085) Benefit Description
• 8.325.10 NMAC- Specialty Services, Emergency Medical Services for Aliens
• Regulatory Impact Form

Written Tribal Notification Letter 20-02

• 8.200.510 NMAC- Medicaid Eligibility- General Recipient Ploicies, Resource Standards
• Regulatory Impact Form

Written Tribal Notification Letters – Comment Period Open – 2019

Written Tribal Notification Letter 19-26

Written Tribal Notification Letter 19-24

Written Tribal Notification Letter 19-18

• List of Not for Profit Community Hospitals effective 10/01/19
• Proposed Outpatient Behavioral Health Fee Schedule Changes effective 10/01/19
• Proposed Fee Schedule for Project ECHO Case Consultations effective 10/01/19

Written Tribal Notification Letter 19-17

• 8.321.2 – Specialized Behavioral Health Services
• Regulatory Impact Form 

Written Tribal Notification Letter 19-16

• Proposed SPA 19-0010 Single State Agency 

Written Tribal Notification Letter 19-14

• 8.320.2 NMAC – Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services
• Regulatory Impact Form

Written Tribal Notification Letter 19-15

• 8.320.6 NMAC – Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Services
• Regulatory Impact Form

Written Tribal Notification Letters – Comment Period Closed – 2020

Written Tribal Notification Letter 20-05

• Draft NM.017.05.04 Medically Fragile Waiver Amendment Application
• Proposed Fee Schedule

Written Tribal Notification Letter 20-01

Draft 1915(c) Home and Community Based Services (HCBS) Supports Waiver Application

On March 11, 2020, Governor Michell Lujan Grisham declared an Executive Order that a Public Health Emergency exists due to the presence of COVID-19 in the State of New Mexico.  Therefore, the Public Hearing for the Supports Waiver Application scheduled for Friday, March 13, 2020 in Santa Fe, New Mexico will be held VIA CONFERENCE CALL ONLY.

 Date: Friday, March 13, 2020

Time: 10:00 a.m., Mountain Time (MT)

Toll-free number: 1-800-747-5150, Access Code: 0440241

The Comment Period has been extended to Friday, March 20, 2020 at 5:00 p.m.

• Draft 1915(c) Home and Community Based Services (HCBS) Supports Waiver Application
• Important Public Hearing Notice ​

Written Tribal Notification Letters – Comment Period Closed – 2019

Written Tibal Notification Letter 19-19

• Draft Mi Via 1915(c) HCBS Waiver Application – 10/01/2020 – 09/30/2025

Written Tribal Notification Letter 19-13

• Proposed SPA 19-0009 Census Bureau Wages Exclusion

Written Tribal Notification Letter 19-12

• Proposed Rates for Inpatient Hospital – DRG Rates
• Proposed Rates for Hospital OPPS

Written Tribal Notification Letter 19-11

Written Tribal Notification Letter 19-10

• Proposed Fee Schedule for Evaluation & Management (E&M) Codes
• Proposed Fee Schedule for Dental Codes
• Proposed Fee Schedule for New Chronic Care Management & Transitional Care Management
• Proposed Rates and Codes for Centennial Care Supoortive Housing

Written Tribal Notification Letter 19-08

• 8.200.410 NMAC – Medicaid Eligibility-General Recipient Rules, General Recipient Requirements
• Regulatory Impact Form

Written Tribal Notification Letter 19-06

• 8.200.510 NMAC – Medicaid Eligibility-General Recipient Rules, Resource Standards
• 8.200.520 NMAC – Medicaid Eligibility-General Recipient Rules, Income Standards
• 8.291.430 NMAC – Medicaid Eligibility-Affordable Care, Financial Responsibility Requirements
• Regulatory Impact Form

Written Tribal Notification Letter 19-05

• Draft Waiver Amendment Application

Written Tribal Notification Letter 19-04

• 8.200.400 NMAC – Medicaid Eligibility – General Recipient Rules, General Medicaid Eligibility
• 8.200.430 NMAC – Medicaid Eligibility – General Recipient Rules, Recipients Rights and Responsibilities
• 8.296.400 NMAC – Medicaid Eligibility – Other Adults, Recipient Requirements
• Regulatory Impact Form

Written Tribal Notification Letter 19-03

• Draft Quality Strategy

Amended Written Tribal Notification Letter 19-02

• Written Tribal Notification Letter- January 11, 2019
• Draft Medically Fragile Waiver Amendment
• Proposed Medically Fragile Waiver Fee Schedule

Written Tribal Notification Letter 19-01

• 8.314.3 Proposed Rule
• Regulatory Impact Form

***The Comment period has been extended until April 4, 2019***

Written Tribal Notification Letters – Comment Period Closed – 2018

Written Tribal Notification Letter 18-01

• Proposed SPA 18-001 Home Equity Exclusion

Written Tribal Notification Letter 18-02

• 8.314.6 NMAC, Mi Via Home and Community-Based Services Waiver

Written Tribal Notification Letter 18-03

• 8.200.410 NMAC, General Recipient Requirement

Written Tribal Notification Letter 18-05

• Proposed SPA 18-002 Health Homes

Written Tribal Notification Letter 18-06

• 8.314.5 NMAC, Developmental Disabilities Home and Community-Based Services Waiver

Written Tribal Notification Letter 18-07

• 8.311.3 NMAC, Methods and Standards for Establishing Payment – Inpatient Hospital Services

Written Tribal Notification Letter 18-14

• Fee Schedule for Behavorial Health Providers 

Written Tribal Notification Letter 18-16

• Proposed SPA 18-003 Individuals Above 133% FPL (Former Foster Care Individuals from Other States up to Age 26)

Written Tribal Notification Letter 18-17

• Draft Waiver Amendment Application
• Proposed Developmental Disabilities Fee Schedule

Written Tribal Notification Letter 18-18

• Proposed Behavioral Health Supplement
• Proposed Behavioral Health Policy and Billing Manual
• Appendix A: Severe emotional disturbance (SED)
• Appendix B: Serious mental illness (SMI)
• Appendix C: Monitoring Tool for Trauma Informed Care (TIC)
• Appendix D: Creating Cultures of Trauma Informed Care
• Appendix E: Promoting Cultural Competence Self-Assessment Checklist for Providers
• Appendix EE: Clinical Supervision Implementation Guide:  A practical implementation guide for community-based behavioral health organizations
• Appendix F: Review Tool for Supervisory Certification
• Appendix G: Supervisory Certification Roster of Approved Agencies
• Appendix H: Supervisory Certification Process Flow
• Appendix I: Supervisory Certification Attestation Form
• Appendix J: Critical Incident Report Form
• Appendix K: Behavioral Health Providers Critical Incident Reporting Protocol
• Appendix M: Tip Sheet for Practitioners in Integrated Care Settings: Practice Principles and Functions for use in behavioral health center
• Appendix N: “Interdisciplinary Teaming in Behavioral HealthCare”
• Appendix O: Practice Standards for Family Teaming
• Appendix P: Highlights of the 1st Four Encounters for Treat First
• Appendix Q: Treat First Approach Protocol
• Appendix R: Adult and Child Self Check-In and Session Check-Out instruments
• Appendix T: Behavioral Health Level of Care Guidelines
• Appendix U: Comprehensive Assessment & Service Plan Adult Form
• Appendix V: Comprehensive Assessment & Service Plan Child Form
• Appendix Y: Healthy Lifestyle Questionnaire
• Appendix YY: Health Lifestyle Questionnaire (Spanish) Cuestionario Respecto a la Salud y la Vida
• Appendix Z: DAST 10: Drug Abuse Screening Test
• Appendix ZA: Audit 10: Alcohol Screen
• Appendix ZB: PHQ9: Patient Health Questionnaire
• Appendix ZC: PCL-C: Post Traumatic Stress Disorder Checklist
• Appendix ZD: GAD-7: Generalized Anxiety Disorder Screen
• Appendix ZE: IOP Attestation Form
• Appendix ZF: IOP Certification Tool
• Appendix ZG: IOP Provider Certification Information
• Appendix ZH: IOP Provider Application
• Appendix ZI: IOP Site Visit Preparation Form
• Appendix ZJ: IOP Process Flow
• Appendix ZK: IOP Site Visit Tool
• Appendix ZL: ACT Readiness Tool
• Appendix ZM: ACT Review Tool
• Appendix ZN: DACTS/G01Scale: Dartmouth Assertive Community Treatment Scale
• Appendix ZO: ACT Chart Audit Tool
• Appendix ZP: ACT Service Audit Tool
• Appendix ZQ: ACT Process Flow
• Appendix ZR: OTP Regulations Crosswalk
• Appendix ZS: OTP Clinic and Personnel Check List
• Appendix ZT: OTP Counselor Questionnaire
• Appendix ZU: OTP Personnel site review form
• Appendix ZV: OTP Patient Record Audit Form
• Appendix ZW: Prudent Parenting and Prevention of Sex Trafficking

Written Tribal Notification Letter 18-19

• Proposed SPA 18-006 Substance Use Disorder
• Proposed SPA 18-007 Substance Use Disorder – Alternative Benefit Plan (ABP)

Written Tribal Notification Letter 18-20

• Proposed Applied Behavior Analysis (ABA) Fee Schedule
• Proposed Behavioral Health (BH) Fee Schedule
• Proposed Physical Health (PH) Fee Schedule

Written Tribal Notification Letter 18-08

• 8.201.400 NMAC, Medicaid Eligibility – Medicaid Extension
• 8.215.400 NMAC, Medicaid Eligibility – Supplemental Security Income (SSI) Methodology
• 8.281.400 NMAC, Medicaid Eligibility – Institutional Care (Categories 081, 083 and 084)
• Comments Received:

Written Tribal Notification Letter 18-09

• 8.308.6 NMAC, Managed Care Organization (MCO) Enrollment
• 8.308.7 NMAC,  Enrollment and Disenrollment
• 8.308.9 NMAC,  Benefit Package
• 8.308.10 NMAC,  Care Coordination
• 8.308.12 NMAC,  Community Benefit

Comments Recevied:

• Comment 1

Written Tribal Notification Letter 18-11

• 8.200.400 NMAC, General Recipient Rules – General Medicaid Eligibility
• 8.201.600 NMAC, Medicaid Extension (Category 01, 03 and 04) – Benefit Description
• 8.215.600 NMAC, Supplemental Security Income (SSI) Methodology – Benefit Description
• 8.231.600 NMAC, Infants of Mothers who are Medicaid or Medical Assistance Program Eligible – Benefit Description
• 8.242.600 NMAC, Medical Assistance Program Eligibility – Qualified Disabled Individuals Whose Income Exceeds QMB and SLIMB – Benefit Description
• 8.243.400 NMAC, Medicaid Eligibility – Working Disabled Individuals (WDI)(Category 043) – Recipient Policies
• 8.243.600 NMAC, Medicaid Eligibility – Working Disabled Individuals (WDI)(Category 043) – Benefit Description
• 8.245.600 NMAC, Medicaid Eligibility – Specified Low Income Medicare Beneficiaries (SLIMB)(Category 045) – Benefit Description
• 8.249.600 NMAC, Medical Assistance Program Eligibility – Refugee Medical Assistance (RMA) Program – Benefit Description
• 8.250.600 NMAC, Medicaid Eligibility – Qualified Individuals Whose Income Exceeds QMB and SLIMB (Category 045) – Benefit Description
• 8.252.600 NMAC, Medical Assistance Program Eligibility – Breast and Cervical Cancer Program – Benefit Description
• 8.280.400 NMAC, Medicaid Eligibility – Program of All Inclusive Care for the Elderly (PACE) – Recipient Policies
• 8.280.600 NMAC, Medicaid Eligibility – Program of All Inclusive Care for the Elderly (PACE) – Benefit Description
• 8.281.600 NMAC, Medicaid Eligibility – Institutional Care (Categories 081, 083 and 084) – Benefit Description
• 8.290.400 NMAC, Medicaid Eligibility – Home and Community-Based Services Waiver (Categories 090, 091, 092, 093, 094, 095 and 096) – Recipient Policies
• 8.290.600 NMAC, Medicaid Eligibility – Home and Community-Based Services Waiver (Categories 090, 091, 092, 093, 094, 095 and 096) – Benefit Description
• 8.292.600 NMAC, Medicaid Eligibility – Parent Caretaker – Benefit Description
• 8.293.600 NMAC, Medicaid Eligibility – Pregnant Women – Benefit Description
• 8.294.600 NMAC, Medicaid Eligibility – Pregnancy-Related Services – Benefit Description
• 8.295.600 NMAC, Medicaid Eligibility – Children Under 19 – Benefit Description
• 8.296.400 NMAC, Medicaid Eligibility – Other Adults – Recipient Requirements
• 8.296.600 NMAC, Medicaid Eligibility – Other Adults – Benefit Description
• 8.297.400 NMAC, Medicaid Eligibility – Loss of Parent Caretaker Medicaid Due to Spousal Support – Recipient Requirements
• 8.297.600 NMAC, Medicaid Eligibility – Loss of Parent Caretaker Medicaid Due to Spousal Support – Benefit Description
• 8.298.400 NMAC, Medicaid Eligibility – Loss of Parent Caretaker Medicaid Due to Earnings from Employment – Recipient Requirements
• 8.298.600 NMAC, Medicaid Eligibility –  Loss of Parent Caretaker Medicaid Due to Earnings from Employment – Benefit Description
• 8.299.400 NMAC, Medicaid Eligibility – Family Planning Services – Recipient Requirements
• 8.299.600 NMAC, Medicaid Eligibility – Family Planning Services – Benefit Description
• 8.302.2 NMAC, Medicaid General Provider Policies – Billing for Medicaid Services

Written Tribal Notification Letter 18-15

• Section 02 Provider Network
• Section 03 Member Education
• Section 04 Care Coordination
• Section 05 Transitions of Care
• Section 06 Nursing Facility Level of Care
• Section 07 Community Benefit
• Section 08 Agency-Based Community Benefit
• Section 09 Self-Directed Community Benefit
• Section 11 Marketing
• Section 12 Patient Centered Initiatives
• Section 14 School Based Health Centers
• Section 16 Fair Hearings
• Section 17 Managed Care Reporting
• Section 18 Quality
• Section 19 Program Integrity
• Section 20 Pharmacy

Written Tribal Notification Letters – Comment Period Closed – 2017

Written Tribal Notification Letter 17-13

• 8.314.3 NMAC, Medically Fragile Home and Community-Based Services Waivers Services

Written Tribal Notification Letter 17-12

• 8.281.510 NMAC, Institutional Care-Trust Standards
• 8.290.600 NMAC, Home and Community-Based Services Waiver-Benefit Description

Written Tribal Notification Letter 17-11

• 8.200.510 NMAC, General Recipient Rules-Resource Standards
• 8.215.500 NMAC, SSI Methodology-Income and Resource Standards
• 8.240.500 NMAC, QMB-Income and Resource Standards
• 8.281.400 NMAC, Institutional Care-Recipient Policies
• 8.281.500 NMAC, Institutional Care-Income and Resource Standards
• 8.290.400 NMAC, Home and Community-Based Services Waiver-Recipient Policies

Written Tribal Notification Letter 17-10

• 8.310.10 NMAC, Health Home Services

Written Tribal Notification Letter 17-09

• 8.308.2 NMAC, Managed Care Program, Provider Network
• 8.308.6 NMAC, Managed Care Program, Eligibility
• 8.308.7 NMAC, Managed Care Program, Enrollment and Disenrollment
• 8.308.8 NMAC, Managed Care Program, Member Education
• 8.308.9 NMAC, Managed Care Program, Benefit Package
• 8.308.10 NMAC, Managed Care Program, Care Coordination
• 8.308.11 NMAC, Managed Care Program, Transition of Care
• 8.308.13 NMAC, Managed Care Program, Member Rewards
• 8.308.15 NMAC, Managed Care Program, Grievances and Appeals
• 8.308.21 NMAC, Managed Care Program, Quality Management
• 8.302.3 NMAC, Medicaid General Provider Policies, Third Party Liability Provider Responsibilities

Written Tribal Notification Letter 17-07

Written Tribal Notification Letter 17-06

• Proposed SPA 17-004-NM Alternative Benefit Plan (ABP)
• Base Benchmark
• ABP Benefits Description

Tribal Notification Letter 17-03

• Proposed SPA 17-003 – Covered Outpatient Drug Rule

Written Tribal Notification Letter 17-02

• Proposed SPA 17-002 Licensed Birth Certificates

Written Tribal Notification Letter 17-01

• G1 –   Cost-Sharing Requirements
• G2a – Cost-Sharing Amounts – Categorically Needy Individuals
• G2c – Cost-Sharing Amounts – Targeting
• G3 –   Cost-Sharing Limitation

Written Tribal Notification Letters – Comment Period Closed – 2016

Written Tribal Notification Letter 16-01

• Section 03 Member Education
• Section 04 Care Coordination
• Section 06 Nursing Facility Level of Care Determination
• Section 07 Community Benefit
• Section 08 Agency Based Community Benefit
• Section 09 Self-Directed Community Benefit
• Section 21 Quality

Written Tribal Consultation Letter 16-02

• Draft CareLink NM Policy Manual
• Draft CareLink NM Plan Template

Written Tribal Consultation Letter 16-03

• New Mexico State Plan Amendment (SPA) 16-01 Pharmacy Dispensing Fee

Written Tribal Consultation Letter 16-04

• New Mexico State Plan Amendment (SPA) 16-003 Tribal Notification Requirements

Written Tribal Consultation Letter 16-05

• New Mexico State Plan Amendment (SPA) 16-02 Alternative Payment Methodology for FQHCs

Written Tribal Consultation Letter 16-07

• 8.308.7 NMAC Managed Care Programs Enrollment and Disenrollment

Written Tribal Consultation Letter 16-08

• Draft Medically Fragile Waiver Renewal Application

Written Tribal Consultation Letter 16-09

• Proposed SPA 16-004 – Terminate Primary Care Provider (PCP) Enhanced Payments
• Proposed SPA 16-005 – Outpatient Hospital Reimbursement
• Proposed SPA 16-006 – Inpatient Hospital Reimbursement
• Proposed SPA 16-007 – Practitioner and Dental Reimbursement

***Comment period extended to June 15, 2016***

Written Tribal Notification Letter 16-10

• Section 03 Member Education
• Section 04 Care Coordination
• Section 11 Marketing
• Section 12 Patient Centered Initiatives
• Section 14 School Based Health Centers
• Section 17 Managed Care Reports

Written Tribal Notification Letter 16-11

• NM Statewide Transition Plan Draft

Written Tribal Notification Letter 16-12

• 8.308.12 NMAC Managed Care Program – Community Benefit

Written Tribal Notification Letter 16-13

• Proposed New Mexico Medicaid Access Monitoring Review Plan for Fee-For-Service Recipients

Written Tribal Notification Letter 16-14

• Draft Mi Via Waiver Amendment Application

***Comment period has been extended to January 2, 2017***

Written Tribal Notification Letter 16-17

• Draft DDW Renewal Application

Written Tribal Notification Letter 16-18

***The comment period for Section 04 Care Coordination has been extended to February 20, 2017***

• Section 02 Provider Network
• Section 04 Care Coordination
• Section 05 Transitions of Care
• Section 07 Community Benefit
• Section 08 Agency Based Community Benefit
• Section 09 Self-Directed Community Benefit
• Section 13 Alternative Benefit Package
• Section 14 School-Based Health Centers
• Section 17 Managed Care Reporting
• Section 17 Managed Care Reporting – Appendix Q

Written Tribal Notification Letters – Comment Period Closed – 2015

Written Tribal Notification Letter 15-25

• 8.314.5 NMAC Developmental Disabilities Waiver Proposed Rule.

Written Tribal Notification Letter 15-24

• Health Home State Plan Amendment
• Attachment 1 – SMI Criteria
• Attachment 2 – SED Criteria
• Attachment 3 – Health Home FFS Payment Summary
• Attachment 4 – CareLink NM Bene Flow

Written Tribal Notificaton Letter 15-22

• 8.314.6 NMAC Mi Via Home and Community-Based Services Proposed Rule

Written Tribal Notification Letter 15-20

• 8.310.10 NMAC Health Home Services Proposed Rule

Written Tribal Consultation Letter 15-19

• New Mexico State Plan Amendment (SPA) 15-07 Concurrent Hospice Care for Children in Medicaid and CHIP 

Written Tribal Consultation Letter 15-18

• 8.200.410 NMAC General Recipient Policies 
• 8.291.430 NMAC Medicaid Eligibility-Affordable Care 

Written Tribal Consultation Letter 15-17

• New Mexico State Plan Amendment (SPA) 15-13 Nursing Facility Rate Increase 

Written Tribal Consultation Letter 15-15

• 8.206.400 NMAC Medicaid Eligibility

Written Tribal Consultation Letter 15-14

• 8.200.510 NMAC General Recipient Proposed Rule Changes

Written Tribal Consultation Letter 15-13

• 8.281.500 NMAC Institutional Care (Categories 081, 083, 084) Proposed Changes

Written Tribal Consultation Letter 15-12

• New Mexico State Plan Amendment (SPA) 15-11 Hospital Based Rural Health Clinics Reimbursement

Written Tribal Consultation Letter 15-11

• New Mexico State Plan Amendment (SPA) 15-10 Former Foster Care Children Attachment- S33

Written Tribal Consultation Letter 15-10

• New Mexico State Plan Amendment (SPA) 15-009 – State Long-Term Insurance Partnership

Written Tribal Consultation Letter 15-09

• New Mexico State Plan Amendment (SPA) 15-05 New Mexico Medicaid School Based Services

Written Tribal Consultation Letter 15-08

• New Mexico State Plan Amendment (SPA) 15-001-Applied Behavior Analysis (ABA) Services and Reimbursement​Transmittal and State Supplement A to Attachment 3.1A pages 5j-5m

Written Tribal Consultation Letter 15-07

• Statewide Home and Community-Base Services Transition Plan Amendment – March 20, 2015

Final federal rule is available on the CMS webpage at: ​

• http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Supports/Home-and-Community-Based-Services/Home-and-Community-Based-Services.html

Written Tribal Consultation Letter 15-05

• New Mexico State Plan Amendment (SPA) 15-001 Attachment 4-19-B
• Applied Behavior Analysis (ABA) Fee Schedule Rates 5.2015

Written Tribal Consultation Letter 15-04

• S12 – Medicaid Eligibility Marriage Policy

Written Tribal Consultation Letter 15-03

• S94 Eligibility Process
• New Mexico Streamline Application
• YES-NM Screen Shots – Part 1
• YES-NM Screen Shots – Part 2
• YES-NM Screen Shots – Part 3

Written Tribal Consultation Letter 15-02

• 8.320.6 NMAC Medicaid School-Based Services Proposed Rule Changes

Written Tribal Consultation Letter 15-01

• New Mexico State Plan Amendment (SPA) 14-14
• Extension of Primary Care Increase (Revised)
• Attachment 4.19-B pages ii.d through f

Written Tribal Consultation Letters – Comment Period Closed – 2014

Written Tribal Consultation Letter 14-19

• Mi Via – 8.314.6 Proposed Rule Changes

Written Tribal Consultation Letter 14-18

• 8.321.2 NMAC Section 10 and Proposed Billing Instructions
• Proposed SPA – ABA
• Proposed SPA – EPSDT
• Proposed SPA – Rehabilitative Services

Written Tribal Consultation Letter 14-17

• 8.206.400 NMAC Proposed Changes
• 8.291.410 NMAC Proposed Changes
• 8.291.430 NMAC Proposed Changes
• 8.293.500 NMAC Proposed Changes
• 8.295.400 NMAC Proposed Changes

Written Tribal Consultation Letter 14-16

• SPA 14-14 – Extension of Primary Care Increase
• Attachment 4.19-B pages ii.d through f

Written Tribal Consultation Letter 14-15

• Community Benefit 8.308.12 NMAC Proposed Changes

Written Tribal Consultation Letter 14-14 

• Developmental Disabilities Waiver Application Renewal to Centers for Medicare and Medicaid Services 2014.

Written Tribal Consultation Letter 14-13

• Transition Plan 
• Attachment #1 CMS Final Rule Crosswalk 
• Copy of Attachment #2 Milestone Timeline 

Written Tribal Consultation Letter 14-12

• 8.314.5 Developmental Disabilities Waiver – Home and Community Based Services Waiver

Written Tribal Consultation Letter 14-11

• Proposed Mi Via HCBS Transition Plan

Written Tribal Consultation Letter 14-10 

• Mi Via Home Community-Based Transition Plan
• Table 1 Assessment of Waiver, Service Standards, NMAC Rule (Mi Via Transition Plan)
• Table 2 Person Centered Planning Process (Mi Via Transition Plan)
• Table 3a-d Mi Via Home and Community-Based (HCB) Setting Assessment (Mi Via Transition Plan)

Written Tribal Consultation Letter 14-09

• Written Tribal Consultation Letter 14-09
• SPA G1 Cost Sharing Requirements
• SPA G2a Cost Sharing Amounts – Categorically Needy Individuals
• SPA G2c Cost Sharing Amounts – Targeting
• SPA G3 Cost Sharing Limitations
• 8.302.2 NMAC Billing for Medicaid Services
• 8.308.14 NMAC Cost Sharing
• 8.309.4 NMAC MAD Administrative Benefits and Limitation of Services
• 8.200.430 NMAC Recipient Rights and Responsibilities
• 8.243.600 NMAC Working Disabled Individuals (WDI) Benefit Description

Written Tribal Consultation Letter 14-08

• Notice of Public Hearing Change
• Written Tribal Consultation Letter 14-08
• S59 Family Planning (SPA)
• 8.200.400 GENERAL MEDICAID ELIGIBILITY
• 8.202.600 BENEFIT DESCRIPTION
• 8.230.600 BENEFIT DESCRIPTION
• 8.235.400 RECIPIENT REQUIREMENTS
• 8.235.500 INCOME AND RESOURCE STANDARDS
• 8.235.600 BENEFIT DESCRIPTION

Written Tribal Consultation Letter 14-07

• 8.310.12 NMAC – Proposed
• State Plan Amendment (Services Provided by IHS)
• State Plan Amendment (Reimbursement For Indian Health Services and Tribal 638 Health Facilities)

Written Tribal Consultation Letter 14-06

• Tribal Consultation Letter 14-06 Mi Via Waiver

Written Tribal Consultation Letter 14-05

• 8.308.12 NMAC – Proposed
• 8.312.2 NMAC – Proposed
• 8.350.2 NMAC – Proposed
• 8.354.2 NMAC – Proposed

Written Tribal Consultation Letter 14​-04

• Attachment A: Chart of Proposed Amendments and Native American Impact
• 8.227.600 NMAC – Proposed
• 8.228.600 NMAC – Proposed
• 8.291.410 NMAC – Proposed
• 8.291.430 NMAC – Proposed
• 8.293.500 NMAC – Proposed

Written Tribal Consultation Letter 14-03

• CURRENT Mi Via Waiver approved April 2013

Written Tribal Consultation Letter 14-02

Proposed Policy Topics for WTCL 14-02
NMAC Number	Policy Topic
8.314.5	Proposed Amendment, Developmental Disabilities Home and Community Based Services Waiver

 

Written Tribal Consultation Letter 14-01

State Plan Amendments (SPAs) – for WTCL 14-01
SPA Number	Policy Topic	Type of SPA
ABP1	Alternative Benefit Plan Populations	Tribal Consultations Draft
ABP2a	Voluntary Benefit Package Selection Assurances	Tribal Consultations Draft
ABP2a	Voluntary Benefit Package Selection Assurances	Tribal Consultations Draft
ABP2c	Enrollment Assurances – Mandatory Participants	Tribal Consultations Draft
ABP3	Selection of Benchmark Benefit Package or Benchmark Equivalent Benefit Package	Tribal Consultations Draft
ABP4	Alternative Benefit Plan Cost-Sharing	Tribal Consultations Draft
ABP5	Benefits Description	Tribal Consultations Draft
ABP7	Benefit Assurances	Tribal Consultations Draft
ABP8	Service Delivery Systems	Tribal Consultations Draft
ABP9	Employer Sponsored Insurance and Payment of Premiums	Tribal Consultations Draft
ABP10	General Assurances	Tribal Consultations Draft
ABP11	Payment Methodology	Tribal Consultation Draft
SPA 13-15	Federal Medical Assistance Percentage (FMAP) Claiming for the New Adult Group	Tribal Consultations Draft
Attachment A to SPA 13-15	A, Part 2 of Modified Adjusted Gross Income (MAGI) Conversion Plan	Tribal Consultations Draft
Attachment E to SPA 13-15	E, New Mexico Transition Plan	Tribal Consultations Draft
SPA A1-A3	Single State Agency	Tribal Consultations Draft
Attachment 4.18a	Alternative Benefit Plan Cost-Sharing	Tribal Consultation Draft
Attachment 4.19b	Payment for Prescription Drugs	Tribal Consultation Draft

 

Proposed Policy Topics for WTCL 14-01
NMAC Number	Policy Topic
8.310.12	Indian Health Services and Tribal Facilities

 

 

 

2013 Written Tribal Consultation Letters

Consultation Letter #1 dated 09.20.13.pdf

Consultation Letter #2 dated 10.08.2013

Consultation Letter #3 Dated 10.23.13 re SPAs.pdf

Consultation Letter #4 dated 10.23.13 re Managed Care Program Benefit Rules.pdf

Consultation Letter #5 dated 10.23.13 re Medical Assistance Provider Rules.pdf

Consultation Letter #6 dated 10.23.13 re Alternative Benefit Program Rules.pdf

2013 Written Tribal Consultation Rules 13-01

8.200.400 General Medicaid Eligibility.pdf

8.200.410 General Recipient Requirements.pdf

8.200.420 Special Recipient Requirements.pdf

8.200.430 Recipient Rights and Responsibilities.pdf

8.200.520 Income Standards.pdf

8.202.400 Recipient Requirements.pdf

8.202.500 Income and Resource Standards.pdf

8.202.600 Benefit Description.pdf

8.206.400 Recipient Requirements.pdf

8.227.400 Recipient Requirements.pdf

8.227.500 Income and Resource Standards.pdf

8.227.500 Income and Resource Standards.pdf

8.227.600 Benefit Description.pdf

8.227.600 Benefit Description.pdf

8.228.400 Recipient Requirements.pdf

8.228.400 Recipient Requirements.pdf

8.228.500 Income and Resource Standards.pdf

8.228.500 Income and Resource Standards.pdf

8.228.600 Benefit Description.pdf

8.228.600 Benefit Description.pdf

8.230.400 Recipient Requirements.pdf

8.230.500 Income and Resource Standards.pdf

8.230.600 Benefit Description.pdf

8.231.600 Benefit Description.pdf

8.232.400 Recipient Requirements.pdf

8.232.500 Income and Resource Standards.pdf

8.232.600 Benefit Description.pdf

8.234.400 Recipient Responsibilities.pdf

8.234.600 Benefit Description.pdf

8.235.400 Recipient Requirements.pdf

8.235.500 Income and Resource Standards.pdf

8.235.600 Benefit Description.pdf

8.242.400 Recipient Requirements.pdf

8.242.500 Income and Resource Standards.pdf

8.242.600 Benefit Description.pdf

8.249.400 Recipient Requirements.pdf

8.249.500 Income and Resource Standards.pdf

8.249.600 Benefit Description.pdf

8.250.400 Recipient Requirements.pdf

8.252.500 Income and Resource Standards.pdf

8.252.600 Benefit Description.pdf

8.259.400 Recipient Requirements.pdf

8.259.500 Income and Resource Standards.pdf

8.259.600 Benefit Description.pdf

8.285.400 Recipient Requirements.pdf

8.291.400 Eligibility Requirements.pdf

8.291.410 General Recipient Requirements.pdf

8.291.420 Recipient Rights and Responsibilities.pdf

8.291.430 Financial Responsiblity Requirements.pdf

8.292.400 Recipient Requirements.pdf

8.292.500 Income and Resource Standards.pdf

8.292.600 Benefit Description.pdf

8.293.400 Recipient Requirements.pdf

8.293.500 Income and Resource Standards.pdf

8.293.600 Benefit Description.pdf

8.294.400 Recipient Requirements.pdf

8.294.500 Income and Resource Standards.pdf

8.294.600 Benefit Description.pdf

8.295.400 Recipient Requirements.pdf

8.295.500 Income and Resource Standards.pdf

8.295.600 Benefit Description.pdf

8.308.22 Fraud, Waste and Abuse.pdf

Eligibility Letter.pdf

2013 Written Tribal Consultation Rules 13-02

8.250.500 Income and Resource Standards.pdf

8.305.1 General Provisions.pdf

8.305.11 Reimbursement for Managed Care.pdf

8.305.12 MCO Member Grievance System.pdf

8.305.12 MCO Member Grievance System.pdf

8.305.13 Fraud and Abuse.pdf

8.305.14 Reporting Requirements.pdf

8.305.15 Services for Individuals with Special Health Care Needs.pdf

8.305.16 Client Transistion of Care.pdf

8.305.17 Value Added Services.pdf

8.305.2 Member Education.pdf

8.305.3 Contract Management.pdf

8.305.4 Managed Care Eligibility.pdf

8.305.4 Managed Care Eligibility.pdf

8.305.4 Managed Care Eligibility.pdf

8.305.4 Managed Care Eligibility.pdf

8.305.5 Enrollment in Managed Care.pdf

8.305.6 Provider Networks.pdf

8.306.1 General Provisions.pdf

8.306.10 Encounters.pdf

8.306.11 Reimbursement.pdf

8.306.12 Member Grievance Resolution.pdf

8.306.13 Fraud and Abuse.pdf

8.306.14 Reporting Requirements.pdf

8.306.15 Services for SCI Members with Special Health Care Needs.pdf

8.306.16 Member Transistion of Care.pdf

8.306.2 Member Education.pdf

8.306.3 Contract Management.pdf

8.306.4 Eligibility.pdf

8.306.5 Enrollment.pdf

8.306.6 Provider Netowrks.pdf

8.306.7 Benefit Package.pdf

8.306.8 Quality Management.pdf

8.306.9 Coordination of Benefits.pdf

8.307.1 General Provisions.pdf

8.307.10 Encounters.pdf

8.307.11 Reimbursement.pdf

8.307.12 Member Grievance Resolution.pdf

8.307.13 Fraud and Abuse.pdf

8.307.14 Reporting Requirements.pdf

8.307.15 Services for Members with Special Health Care Needs.pdf

8.307.16 Client Transistion of Care.pdf

8.307.17 Value Added Services.pdf

8.307.18 CoLTS 1915 (c) Home and Community-Based Services Waiver.pdf

8.307.2 Member Education.pdf

8.307.3 Contract Management.pdf

8.307.4 Eligibility.pdf

8.307.5 Enrollment.pdf

8.307.6 Provider Networks.pdf

8.307.7 Benefit Package.pdf

8.307.8 Quality Management.pdf

8.307.9 Coordination of Services.pdf

8.310.12 IHS and Tribal 638 Facilities.pdf

8.310.2 General Benefit Description.pdf

8.310.3 Professional Providers and Reimbursement.pdf

8.320.2 Early, Periodic Screening, Diagnosis and Treatment Services (EPSDT).pdf

8.320.6 School Based Services for MAP Eligible Recipients under Twenty-One Years of Age.pdf

8.324.4 Pharmacy Services, Perscribing and Practitioner Administered Drug Items.pdf

8.324.5 Vision Appliances, Hearing Appliances, Durable Medical Equipment, Oxygen, Medical Supplies, Prosthetics & Orthotic.pdf

8.324.7 Transportation Services and Lodging.pdf

2013 Written Tribal Consultation Rules 13-03

CS14 Children who lose Medicaid due to loss of disregards – Tribal Consultation draft.pdf

CS3 Eligibility for Medicaid Expansion Program – Tribal Consultation draft.pdf

S10 MAGI Income Methodology – Tribal Consultation draft.pdf

S14 AFDC Income Standard – Tribal Consutlation draft.pdf

S21 Hospital Presumptive Eligibility – Tribal Consultation draft.pdf

S25 Parents and Other Caretakers – Tribal Consultation draft.pdf

S28 Pregnant Women – Tribal Consultation draft.pdf

S30 Infants and Children Under Age 19 – Tribal Consultation draft.pdf

S33 Former Foster Care Children up to age 26 – Tribal Consultation draft.pdf

S51 Optional Parents and Caretakers – Tribal Consultation draft.pdf

S52 Reasonable Classification of Individuals – Tribal Consultation draft.pdf

S53 Non IV-E Adoption Assistance – Tribal Consultation draft.pdf

S54 Optional Targeted Low Income Children – Tribal Consultation draft.pdf

S55 Tuberculosis – Tribal Consultation draft.pdf

S57 Foster Care Adolescents – Chafee – Tribal Consultation draft.pdf

S59 Family Planning – Tribal Consutltation draft.pdf

S88 Residency – Tribal Consultation draft.pdf

S89 Citizenship and Immigration Status – Tribal Consultation draft.pdf

Training Materials MOSAA and PE.pdf

2013 Written Tribal Consultation Rules 13-04

8.302.2 NMAC Billing for Medicaid Services.pdf

8.321.2 Specialized Behavioral Health Provider Enrollment and Reimbursement.pdf

8.351.2 Sanctions and Remedies.pdf

8.352.2 Claimant Hearings.pdf

8.352.3 Provider Hearings.pdf

2013 Written Tribal Consultation Rules 13-05

8.308.12 Community Benefit.pdf

8.308.13 Member Rewards.pdf

8.308.14 Cost Sharing.pdf

8.308.9 Benefit Package.pdf

2013 Written Tribal Consultation Rules 13-06

8.309.4 MAD Administered Benefits and Limitation of Services.pdf