N.M. Stat. § 59A-24A-15
Medicare supplement policy; provisions relating to
individuals who are eligible for medical benefits under the medicaid
program.
A. Each medicare supplement policy that is delivered, issued for delivery or
renewed in this state shall include provisions that require benefits paid on behalf of a
child or other insured person under the policy to be paid to the human services
department [health care authority department] when:
(1)
the human services department [health care authority department] has
paid or is paying benefits on behalf of the child or other insured person under the state's
medicaid program pursuant to Title XIX of the federal Social Security Act, 42 U.S.C.
1396, et seq.;
(2)
payment for the services in question has been made by the human
services department [health care authority department] to the medicaid provider; and
(3)
the issuer is notified that the insured individual receives benefits under the
medicaid program and that benefits must be paid directly to the human services
department [health care authority department].
B. The notice required under Paragraph (3) of Subsection A of this section may be
accomplished through an attachment to the claim by the human services department
[health care authority department] for insurance benefits when the claim is first
submitted by the human services department [health care authority department] to the
issuer.
C. Notwithstanding any other provisions of law, checks in payment for claims
pursuant to any medicare supplement policy for health care services provided to
persons who are also eligible for benefits under the medicaid program and provided by
medical providers qualified to participate under the policy shall be made payable to the
provider. The issuer may be notified that the insured individual is eligible for medicaid
benefits through an attachment to the claim by the provider for insurance benefits when
the claim is first submitted by the provider to the issuer.
D. No medicare supplement policy delivered, issued for delivery or renewed in this
state or after the effective date of this section shall contain any provision denying or
limiting insurance benefits because services are rendered to an insured who is eligible
for or who has received medical assistance under the medicaid program of this state,
unless:
(1)
the medicare supplement policy or certificate has been suspended at the
request of a policy or certificate holder for a period not to exceed twenty-four months;
and
(2)
during the period of suspension, the policy or certificate holder is entitled
to medical assistance pursuant to Title XIX of the federal Social Security Act, 42 U.S.C.
1396, et seq.