HOUSE BILL 130

49th legislature - STATE OF NEW MEXICO - first session, 2009

INTRODUCED BY

Mimi Stewart

AN ACT

RELATING TO PUBLIC ASSISTANCE; ENACTING NEW SECTIONS OF THE PUBLIC ASSISTANCE ACT; REQUIRING THE HUMAN SERVICES DEPARTMENT TO MAKE MONTHLY PUBLIC REPORTS AND TO RETAIN DOCUMENTATION ON MEDICAID AND THE STATE CHILDREN'S HEALTH INSURANCE PROGRAM ENROLLMENT AND RETENTION.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     Section 1. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] MEDICAID AND THE STATE CHILDREN'S HEALTH INSURANCE PROGRAM ENROLLMENT REPORTING REQUIREMENT.--The department shall make available to the public on an internet web site that the department maintains, and through publication of a monthly statistical report, data to assess the enrollment and retention of individuals who are eligible for medicaid or the state children's health insurance program, including:

          A. annual budget projections and expenditures by category of eligibility;

          B. monthly point-in-time numbers of enrolled recipients, listed by each category of eligibility, showing the number of individuals actually enrolled in medicaid or the state children's health insurance program at the time of reporting and made publicly available within thirty days after the month has ended;

          C. monthly denial rates for medicaid and the state children's health insurance program, including for each month:

                (1) the number of applications that the department received;

                (2) the number of applications that the department approved;

                (3) the number of applications that the department denied; and

                (4) for those applications denied, the number of cases denied and the denial code, listed according to the following reasons for denial:

                     (a) income or asset ineligibility;

                     (b) voluntary withdrawal;

                     (c) procedural denial;

                     (d) categorical ineligibility; or

                     (e) any other reason;

                  D. monthly termination rates of medicaid and state children's health insurance program cases, including for each month:

                (1) the number of cases due for renewal;

                (2) the number of renewals received;

                (3) the number of renewals approved;

                (4) the number of renewals denied;

                (5) the number of recipients whose cases were terminated, listed according to the reason for termination by code; and

                (6) the number of recipients that the department disenrolled and reinstated within six months; and

          E. any other data that would be useful to consider in analyzing the effectiveness of medicaid and state children's health insurance program case enrollment and retention policies."

     Section 2. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] MEDICAID AND STATE CHILDREN'S HEALTH INSURANCE PROGRAM ENROLLMENT DOCUMENTATION.--In order to evaluate the accuracy of eligibility determinations, the department shall document and store the following information within individual medicaid and state children's health insurance program records for no less than three years:

          A. a complete record of the reasons that the department denied or terminated enrollment; and

          B. efforts that the department has taken to ensure that medicaid and state children's health insurance program applicants and recipients receive adequate and timely notification of specific steps that must be taken to complete applications or to recertify eligibility for benefits."

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