As used in the Indigent Hospital and County Health Care Act:
A. "ambulance provider" or "ambulance service" means a specialized carrier based within the state authorized under provisions and subject to limitations as provided in individual carrier certificates issued by the public regulation commission to transport persons alive, dead or dying en route by means of ambulance service. The rates and charges established by public regulation commission tariff shall govern as to allowable cost. Also included are air ambulance services approved by the county. The air ambulance service charges shall be filed and approved pursuant to Subsection D of Section 27-5-6 NMSA 1978 and Section 27-5-11 NMSA 1978;
B. "cost" means all allowable costs of providing health care services, to the extent determined by resolution of a county, for an indigent patient. Allowable costs shall be based on medicaid fee-for-service reimbursement rates for hospitals, licensed medical doctors and osteopathic physicians;
C. "county" means a county except a class A county with a county hospital operated and maintained pursuant to a lease or operating agreement with a state educational institution named in Article 12, Section 11 of the constitution of New Mexico;
D. "department" means the human services department;
E. "fund" means a county health care assistance fund;
F. "health care services" means treatment and services designed to promote improved health in the county indigent population, including primary care, prenatal care, dental care, behavioral health care, alcohol or drug detoxification and rehabilitation, hospital care, provision of prescription drugs, preventive care or health outreach services, to the extent determined by resolution of the county;
G. "indigent patient" means a person to whom an ambulance service, a hospital or a health care provider has provided medical care, ambulance transportation or health care services and who can normally support the person's self and the person's dependents on present income and liquid assets available to the person but, taking into consideration the person's income, assets and requirements for other necessities of life for the person and the person's dependents, is unable to pay the cost of the ambulance transportation or medical care administered or both; provided that if a definition of "indigent patient" is adopted by a county in a resolution, the definition shall not include any person whose annual income together with that person's spouse's annual income totals an amount that is fifty percent greater than the per capita personal income for New Mexico as shown for the most recent year available in the survey of current business published by the United States department of commerce. "Indigent patient" includes a minor who has received ambulance transportation or medical care or both and whose parent or the person having custody of that minor would qualify as an indigent patient if transported by ambulance, admitted to a hospital for care or treated by a health care provider;
H. "medicaid eligible" means a person who is eligible for medical assistance from the department;
I. "planning" means the development of a countywide or multicounty health plan to improve and fund health services in the county based on the county's needs assessment and inventory of existing services and resources and that demonstrates coordination between the county and state and local health planning efforts;
J. "public entity" means a state, local or tribal government or other political subdivision or agency of that government; and
K. "qualifying hospital" means an acute care general hospital licensed by the department of health that is qualified to receive payments from the safety net care pool pursuant to an agreement with the federal centers for medicare and medicaid services.
History: 1953 Comp., § 13-2-15, enacted by Laws 1965, ch. 234, § 4; 1975, ch. 44, § 1; 1977, ch. 253, § 43; 1978, ch. 123, § 1; 1979, ch. 146, § 1; 1983, ch. 234, § 2; 1987, ch. 50, § 1; 1987, ch. 88, § 2; 1990, ch. 37, § 1; 1991, ch. 171, § 1; 1991, ch. 212, § 19; 1993, ch. 321, § 4; 1997, ch. 51, § 2; 1999, ch. 37, § 1; 1999, ch. 270, § 4; 2001, ch. 30, § 1; 2001, ch. 272, § 1; 2001, ch. 280, § 1; 2003, ch. 413, § 2; 2004, ch. 94, § 1; 2012, ch. 18, § 1; 2014, ch. 79, § 6.
ANNOTATIONSThe 2014 amendment, effective March 12, 2014, eliminated terms to comply with changes in federal regulations regarding the replacement of sole community providers with qualifying hospitals; deleted former Subsection A, which defined "alcohol rehabilitation center"; deleted former Subsection C, which defined "board"; deleted former Subsection D, which defined "commission"; deleted former Subsection H, which defined "drug rehabilitation center"; deleted former Subsection J, which defined "health care provider"; deleted former Subsection L, which defined "hospital"; deleted former Subsection O, which defined "mental health center"; deleted former Subsection R, which defined "sole community provider"; deleted former Subsection S, which defined "tribal"; in Subsection A, in the third sentence, after "approved by the", deleted "board" and added "county"; in Subsection B, in the first sentence, after "resolution of a", deleted "board" and added "county"; in Subsection C, after "pursuant to a lease", added "or operating agreement"; in Subsection E, after "means a county", deleted "indigent hospital claims" and added "health care assistance"; in Subsection F, after "dental care", added "behavioral health care, alcohol or drug detoxification and rehabilitation, hospital care", and after "resolution of the", deleted "board" and added "county"; in Subsection G, in the first sentence, after "adopted by a", deleted "board" and added "county", and deleted the former second sentence, which provided that "Every board that has a balance remaining in the fund at the end of a given fiscal year shall consider and may adopt at the first meeting of the succeeding fiscal year a resolution increasing the standard for indigence"; and added a new Subsection K.
The 2012 amendment, effective March 1, 2012, alphabetically arranged defined terms and added definitions of new terms; added a new Subsection A and deleted former Subsection L to define "alcohol rehabilitation center"; added a new Subsection D and deleted former Subsection Q to define "commission"; added a new Subsection I and deleted former Subsection F to define "fund"; added a new Subsection L and deleted former Subsection D to define "hospital"; added a new Subsection M and deleted former Subsection C to define "indigent patient"; added a new Subsection N and deleted former Subsection G to define "medicaid eligible"; added a new Subsection O and deleted former Subsection M to define "mental health center"; added a new Subsection Q to define "public entity"; added Subsection R and deleted former Subsection J to define "sole community provider hospital"; added Subsection S to define "tribal"; and relettered the following: former Subsections A and B as Subsections B and C; former Subsections H and I as Subsections F and G; former Subsection K as Subsection H; former Subsection N as Subsection J; and former Subsection O as Subsection K.
The 2004 amendment, effective July 1, 2004, amended Subsection N to add new Paragraph (10).
The 2003 amendment, effective June 20, 2003, in Subsection C, deleted "or" following "transported by ambulance", deleted "or all three" at the end; rewrote Subsection E; deleted "established in 42 C.F.R. 412.92 pursuant to Title 18 of the federal Social Security Act" near the end of Paragraph J(1); and substituted "providing emergency services, as determined by the board, in a hospital to an indigent patient" for "providing services in a hospital or outpatient setting that are necessary for conditions that endanger the life of or threaten permanent disability to an indigent patient" at the end of Paragraph N(9).
The 2001 amendment, effective June 15, 2001, added Paragraphs J(2), N(9), and added Subsection Q.
The 1999 amendment, effective July 1, 1999, substituted "public regulation commission" for "state corporation commission" twice in Subsection A; substituted "set by the department of health" for "pursuant to the Drug Abuse Act" in Subsection K; deleted "pursuant to the Alcoholism and Alcohol Abuse Prevention, Screening and Treatment Act" at the end of Subsection L; and deleted "pursuant to the Community Mental Health Act" at the end of Subsection M.
The 1997 amendment, effective June 20, 1997, made minor stylistic changes throughout the section; in Subsection C, inserted "or health care services" following "ambulance transportation" in the first sentence; in Subsection E, substituted "or costs of providing health care services" for "including the costs of prenatal care" in the first sentence; and added Subsections O and P.
The 1993 amendment, effective July 1, 1993, substituted "and County Health Care" for "Claims" in the introductory language; substituted "and county health care" for "claims" in Subsection B; in Subsection C, substituted "a hospital or a health care provider" for "or a hospital" in the first sentence and "or treated by a health care provider or all three" for "or both" in the last sentence, and made a stylistic change in the second sentence; in Subsection D, rewrote the introductory language and deleted former Paragraphs (3) and (5) through (8), the provisions of which may now be found in Subsection N, renumbering former Paragrph (4) as Paragraph (3) and making a related grammatical change; substituted "health care provider" for "nursing home" near the end of Subsection E; rewrote Subsections G and H, and added Subsections J through N.
The 1991 amendment, effective July 1, 1991, in Subsection C, added the third sentence; and, in Subsection D, added the exception at the end of the introductory paragraph, deleted a sentence at the end of Paragraph (7) which read "All hospitals, as defined in this subsection, must comply with the provisions of the Indigent Hospital Claims Act and be licensed by the health and environment department", and added Paragraph (8).
Definition of "indigent patient" was not unconstitutional under N.M. Const., art. IX, § 14. Humana of N.M., Inc. v. Board of Cnty. Comm'rs, 1978-NMSC-036, 92 N.M. 34, 582 P.2d 806.
Validity of amendment by Laws 1999, ch. 37, § 1. — Although the amendment of this section by Laws 1999, ch. 37, § 1, was not codified pursuant to Section 12-1-8 NMSA 1978, the amendment is valid and in effect. 2000 Op. Att'y Gen. No. 00-05.