A. Consistent with the federal act and subject to the appropriation and availability of federal and state funds, the medical assistance division of the department may by rule provide medical assistance, including the services of licensed doctors of oriental medicine, licensed chiropractic physicians, licensed dental therapists and licensed dental hygienists in collaborating practice, to persons eligible for public assistance programs under the federal act.
B. Subject to appropriation and availability of federal, state or other funds received by the state from public or private grants or donations, the medical assistance division of the department may by rule provide medical assistance, including assistance in the payment of premiums for medical or long-term care insurance, to children up to the age of twelve if not part of a sibling group; children up to the age of eighteen if part of a sibling group that includes a child up to the age of twelve; and pregnant women who are residents of the state of New Mexico and who are ineligible for public assistance under the federal act. The department, in implementing the provisions of this subsection, shall:
(1) establish rules that encourage pregnant women to participate in prenatal care; and
(2) not provide a benefit package that exceeds the benefit package provided to state employees.
History: 1953 Comp., § 13-17-15, enacted by Laws 1973, ch. 376, § 16; 1991, ch. 144, § 1; 1993, ch. 158, § 1; 2003, ch. 343, § 1; 2006, ch. 2, § 1; 2019, ch. 107, § 15.
ANNOTATIONSCross references. — For meaning of "federal act", see 27-2-2 NMSA 1978.
For payment for hospital care, see 27-2-9 NMSA 1978.
The 2019 amendment, effective June 14, 2019, included the services of licensed dental therapists within the provisions of the medical assistance programs; and in Subsection A, added "licensed dental therapists".
The 1991 amendment, effective June 14, 1991, substituted "medical assistance division of the human services department" for "board" and inserted "including the services of licensed oriental medical doctors and licensed chiropractors".
The 2006 amendment, effective May 17, 2006, added Subsection B to provide for medical assistance, including payment of insurance premiums, for children and pregnant women ineligible for federally funded public assistance.
The 2003 amendment, effective June 20, 2003, inserted "chiropractic physicians and licensed dental hygienists in collaborative practice" near the end.
The 1993 amendment, effective June 18, 1993, substituted "licensed doctors of oriental medicine" for "licensed oriental medical doctors".
Abortions. — Rule prohibiting the use of state funds to pay for abortions for medicaid-eligible women, except when necessary to save the life of the mother, to end an ectopic pregnancy, or when the pregnancy resulted from rape or incest violates the equal rights amendment to N.M. Const., art. II, § 18. N.M. Right to Choose/NARAL v. Johnson, 1999-NMSC-005, 126 N.M. 788, 975 P.2d 841, cert. denied, 526 U.S. 1020, 119 S. Ct. 1256, 143 L. Ed. 2d 352 (1999).
Chiropractors' services not required under state medicaid program. — Chiropractors' services are not physicians' services under the medicaid program. Chiropractors' services thus are not included in the general categories of medical treatment which must be included in the state plan. Katz v. N.M. Dep't of Human Servs., 1981-NMSC-012, 95 N.M. 530, 624 P.2d 39 (decided prior to 1991 amendment).
Services of a physical therapist are not required to be included in the state plan. Katz v. N.M. Dep't of Human Servs., 1981-NMSC-012, 95 N.M. 530, 624 P.2d 39.
Denial of services not denial of equal protection. — The denial of medicaid benefits for the services of chiropractors and physical therapists is not so arbitrary and unreasonable as to constitute a denial of equal protection. Katz v. N.M. Dep't of Human Servs., 1981-NMSC-012, 95 N.M. 530, 624 P.2d 39 (decided prior to 1991 amendment).
Medical assistance division does not have the authority to resolve discrimination claims. — Where petitioner, a member of a managed care organization (MCO) that contracts with the human services department (HSD) to administer the provision of medicaid benefits and services, including non-emergency medical transportation, to eligible members, made requests of the MCO, pursuant to Title II of the Americans with Disabilities Act of 1990 (ADA Title II) and Section 504 of the federal Rehabilitation Act, for certain accommodations in the provision of transportation services, and where the MCO denied petitioner's request for reasonable accommodations in accessing medicaid services, and where petitioner requested a fair hearing to appeal the failure of the MCO and HSD to grant her reasonable accommodations in medicaid transportation services, the district court did not err in affirming HSD's medical assistance division's (division) dismissal of the matter, because neither the Public Assistance Act nor the Medicaid Act relied on by petitioner expressly grants the division the power to resolve discrimination claims raised by a medicaid beneficiary challenging an agency's denial or inaction in response to a request for accommodation, nor is any such power vested in the division by any regulation promulgated under state law. Law v. N.M. Human Servs. Dep't, 2019-NMCA-066, cert. denied.
Law reviews. — For article, "Freedom at Home State Constitutions and Medicaid Funding for Abortions", see 26 N. M. L. Rev. 433 (1996).
Am. Jur. 2d, A.L.R. and C.J.S. references. — Transsexual surgery as covered operation under state medical assistance program, 2 A.L.R.4th 775.
Limitation on right of chiropractors and osteopathic physicians to participate in public medical welfare programs, 8 A.L.R.4th 1056.