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                                                                                 Center for Connected Health Policy

           New Mexico


           Medicaid Program:  New Mexico Medicaid

           Medicaid Program Administrator:  New Mexico Human Services Dept., Medical Assistance Division (MAD)

           Regional Telehealth Resource Center:
           Southwest Telehealth Resource Center
           PO Box 245105
           Tucson, AZ 85724
           (520) 626-4498
           www.southwesttrc.org


            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

            Definition of telemedicine/telehealth
            “Telemedicine means the practice of medicine across   No reference found.
            state lines.”

            Source: NM Administrative Code, 16.10.2.7 (2012).

            Telemedicine means the use of interactive simultaneous
            audio and video or store-and-forward technology using
            information and telecommunications technologies by a
            health care provider to deliver health care services at a
            site other than the site where the patient is located,
            including the use of electronic media for consultation
            relating to the health care diagnosis or treatment of the
            patient in real time or through the use of store-and-
            forward technology.

            Source: NM Statute. 59A-22-49.3.

            “The practice of medicine across state lines means the
            rendering of a written or otherwise documented medical
            opinion concerning diagnosis or treatment of a patient
            within this state, by a physician located outside this
            state, as a result of transmission of individual patient
            data by electronic, telephonic or other means from within
            this state, to the physician or the physician’s agent, OR
            the rendering of treatment to a patient within this state,
            by a physician located outside this state, as a result of
            transmission of individual patient data by electronic,
            telephonic or other means from within this state to the
            physician or the physician’s agent.”

            Source: NM Statutes Annotated, 1978 Sec. 61-6-6 (2012).

            "Telehealth means the use of electronic information,
            imaging and communication technologies, including
            interactive audio, video and data communications as
            well as store-and-forward technologies, to provide and
            support health care delivery, diagnosis, consultation,
            treatment, transfer of medical data and education.”

            Source: NM Statutes Annotated Sec. 24-1G-3 (2012).

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                                                                                 Center for Connected Health Policy

            Live Video Reimbursement

            New Mexico statute encourages the use and          New Mexico Medicaid will reimburse for live video at the
            reimbursement of telehealth, which includes live video.   same rate as when the services are furnished without
                                                               the use of a telecommunication system.
            Source: NM Statutes Annotated, Sec. 24-25-5 (2012).
                                                               Source: NM Administrative Code 8.310.2.
            Private payers are required to provide coverage for
            services delivered through live video, equivalent to in-  Telemedicine is also covered by NM Managed Care.
            person coverage.
                                                               Source: NM Medical Assistance Division Managed Care Policy
            Source: NM Statute. 59A-22-49.3.                   Manual. Aug. 15, 2014.

            (also see Medicaid column)                         Alternative Benefits Program & Managed Care
                                                               Program

                                                               The benefits package includes telemedicine services.

                                                               Source: NM Admin Code Sec. 8.309.4.16 & 8.308.9.18.
            Store and Forward Reimbursement
            New Mexico Statute defines telehealth as encompassing  New Mexico Medicaid does reimburse for store and
            Store and Forward.                                 forward.  To be eligible, the service must be provided
                                                               through the transfer of digital images, sounds, or
            Source: NM Statutes Annotated Sec. 24-1G-3 (2012).   previously recorded video from one location to another.
                                                               It does not need to occur in real time.
            Private payers are required to provide coverage for
            services delivered through store and forward, equivalent   Source: NM Administrative Code 8.310.2.
            to in-person coverage.

            Source: NM Statute. 59A-22-49.3.

            Remote Patient Monitoring Reimbursement
            No reference found.                                No reference found.
            Email/Phone/FAX Restrictions

            No reference found.                                No reference found.
            Online Prescribing

            Physicians are prohibited from prescribing, dispensing   No reference found.
            or administering drugs or medical supplies to a patient
            when there is no established physician-patient
            relationship.

            This includes prescribing over the Internet, or via other
            electronic means, based solely on an online
            questionnaire.

            Physicians may prescribe online during a live video
            exam. The prescribing physician must:

                •   Obtain a medical history;
                •   Obtain informed consent;
                •   Generate a medical record;
                •   A physical exam is recorded as appropriate by
                    the telehealth practitioner or a practitioner such
                    as a physician, advance practice nurse, or
                    physician or anesthesiologist assistant; or the

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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

                    exam is waived when a physical exam would
                    not normally be part of a typical physical face-
                    to-face encounter with the patient for the
                    services being provided.

            Source: NM Statutes Annotated, 1978 Sec. 61-6-20(B).
            Consent

            No reference found.                                No reference found.
            Location
            No reference found.                                An interactive telehealth communication system must
                                                               include both interactive audio and video, and be
                                                               delivered on a real-time basis at both the originating and
                                                               distant sites.

                                                               The originating site can be any medically warranted site.

                                                               Source: NM Administrative Code 8.310.2.
            Cross-State Licensing
            NM issues telemedicine licenses to providers who hold a  When the originating site is in New Mexico and the
            full, unrestricted license in another state and has good   distant site is outside New Mexico, the distant-site
            moral character.                                   provider at the distant site must be licensed in New
                                                               Mexico for telemedicine, or meet federal requirements
            Source: NM Statutes Annotated, 1978 Sec. 61-6-11.1 (Sunset date   for Indian Health Service or tribal contract facilities.
            of July 1, 2016) and 16.10.2.11.
                                                               Source: NM Administrative Code 8.310.2.
            Private Payers

            Private payers are required to provide coverage for   No reference found.
            services delivered through telemedicine, consistent with
            in-person coverage.

            Source: NM Statute. 59A-22-49.3.
            Site/Transmission Fee

            Indian Health Services                             Reimbursement is made to the originating site for an
            A telemedicine facility fee is paid. Both the originating   interactive telehealth system fee at the lesser of the
            and distant sites may be IHS or tribal facilities with two   following:
            different locations, or a distant site can be under
            contract to the IHS or tribal facility.                •   Provider's billed charge;
                                                                   •   Maximum allowed by MAD for the specific
            Source: NM Administrative Code 8.310.12.12.                service or procedure.
                                                                   •   A telemedicine originating-site communication
                                                                       fee is also covered if the eligible recipient was
                                                                       present at and participated in the telemedicine
                                                                       visit at the originating site.

                                                               Source: NM Administrative Code 8.310.2.

                                                               An originating site facility fee is not payable if
                                                               telemedicine is used to connect an employee or staff
                                                               member of a facility to the eligible recipient being seen
                                                               at the same facility.


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM


                                                               Source: NM Register. Volume XXV, No. 20. Oct. 30, 2014.
            Miscellaneous



           Comment:      New Mexico offers out of state providers a "telemedicine license" to practice within its borders.

                         New Mexico is also the home of Project ECHO.  The project's mission is to develop the capacity to
                         safely and effectively treat chronic, common, and complex diseases in rural and underserved areas,
                         and to monitor outcomes of this treatment utilizing technology.

































































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