2009 New Mexico Statutes
Chapter 27 - Public Assistance.
Article 5 - Indigent Hospital and County Health Care
Section 27-5-6 - Powers and duties of the board.

27-5-6. Powers and duties of the board.

The board:   

A.     shall administer claims pursuant to the provisions of the Indigent Hospital and County Health Care Act [27-5-1 NMSA 1978];   

B.     shall prepare and submit a budget to the board of county commissioners for the amount needed to defray claims made upon the fund and to pay costs of administration of the Indigent Hospital and County Health Care Act and costs of development of a countywide or multicounty health plan. The combined costs of administration and planning shall not exceed the following percentages of revenues based on the previous fiscal year revenues for a fund that has existed for at least one fiscal year or based on projected revenues for the year being budgeted for a fund that has existed for less than one fiscal year. The percentage of the revenues in the fund that may be used for such combined administrative and planning costs is equal to the sum of the following:   

(1)     ten percent of the amount of the revenues in the fund not over five hundred thousand dollars ($500,000);   

(2)     eight percent of the amount of the revenues in the fund over five hundred thousand dollars ($500,000) but not over one million dollars ($1,000,000); and   

(3)     four and one-half percent of the amount of the revenues in the fund over one million dollars ($1,000,000);   

C.     shall make rules necessary to carry out the provisions of the Indigent Hospital and County Health Care Act; provided that the standards for eligibility and allowable costs for county indigent patients shall be no more restrictive than the standards for eligibility and allowable costs prior to December 31, 1992;   

D.     shall set criteria and cost limitations for medical care furnished by licensed out-of-state hospitals, ambulance services or health care providers;   

E.     shall cooperate with appropriate state agencies to use available funds efficiently and to make health care more available;   

F.     shall cooperate with the department in making an investigation to determine the validity of claims made upon the fund for an indigent patient;   

G.     may accept contributions or other county revenues, which shall be deposited in the fund;   

H.     may hire personnel to carry out the provisions of the Indigent Hospital and County Health Care Act;   

I.     shall review all claims presented by a hospital, ambulance service or health care provider to determine compliance with the rules adopted by the board or with the provisions of the Indigent Hospital and County Health Care Act; determine whether the patient for whom the claim is made is an indigent patient; and determine the allowable medical, ambulance service or health care services costs; provided that the burden of proof of any claim shall be upon the hospital, ambulance service or health care provider;   

J.     shall state in writing the reason for rejecting or disapproving any claim and shall notify the submitting hospital, ambulance service or health care provider of the decision within sixty days after eligibility for claim payment has been determined;   

K.     shall pay all claims that are not matched with federal funds under the state medicaid program and that have been approved by the board from the fund and shall make payment within thirty days after approval of a claim by the board;   

L.     shall determine by county ordinance the types of health care providers that will be eligible to submit claims under the Indigent Hospital and County Health Care Act;   

M.     shall review, verify and approve all medicaid sole community provider hospital payment requests in accordance with rules adopted by the board prior to their submittal by the hospital to the department for payment but no later than January 1 of each year;   

N.     shall transfer to the state by the last day of March, June, September and December of each year an amount equal to one-fourth of the county's payment for support of sole community provider payments as calculated by the department for that county for the current fiscal year. This money shall be deposited in the sole community provider fund;   

O.     shall, in carrying out the provisions of the Indigent Hospital and County Health Care Act, comply with the standards of the federal Health Insurance Portability and Accountability Act of 1996;   

P.     may provide for the transfer of money from the fund to the county-supported medicaid fund to meet the requirements of the Statewide Health Care Act [27-10-1 NMSA 1978]; and   

Q.     may contract with ambulance providers, hospitals or health care providers for the provision of health care services.