Press releases

NM, federal officials reach deal on revamped state Medicaid program

Release Date: 3/5/2013

Dennis Domrzalski
Albuquerque Business First

Federal Medicaid officials have reached an agreement with the New Mexico Human Services Department on key aspects of the state’s revamped Medicaid program, HSD said Tuesday.

The U.S. Centers for Medicare and Medicaid Services and HSD have reached an agreement in principle on several waivers the state had sought for its Centennial Care Medicaid program, HSD said in a news release.

The agreement includes using a coordinated care model for the state’s 560,000 Medicaid recipients, co-payments for nonemergency use of the emergency room and the use of primary care doctors to encourage health behaviors to prevent health problems and chronic diseases.

“We are glad to see that CMS recognizes the central focus of Centennial Care is a robust care coordination system that will help ensure that recipients receive the care they need to stay as healthy as they can,” HSD Secretary Sidonie Squier said. “We will likely see improved health outcomes and healthier New Mexicans in years to come.”

Medicaid is a joint $4 billion federal-state program that provides health insurance mainly to children of low-income families. About 70 percent of the program is paid for by the federal government.

New Mexico’s Medicaid rolls are expected to climb to 700,000 after 2014, when adults who earn up to 138 percent of the federal poverty level are eligible for the program.

Like many insurers, HSD is trying to move the Medicaid program away from a fee-for-service model where doctors are paid for every procedure they do and test they order. The coordinated care model uses teams of health care providers, including doctors, nutritionists and mental health experts, to keep people healthy and out of hospitals.


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