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- Title 8. Social Services
- Chapter 310. Health Care Professional Services
- Part 12. Indian Health Service and Tribal 638 Facilities
N.M. Code R. § 8.310.12.13 Prior Authorization and Utilization Review
| Library | New Mexico Administrative Code |
| Edition | 2023 |
| Currency | Current through Register Vol. 34, No. 24, December 19, 2023 |
| Citation | N.M. Code R. § 8.310.12.13 |
| Year | 2023 |
IHS and tribal 638 facilities need not obtain prior authorization for services, but must continue to follow standards of care within its scope of practice and retain documentation in the eligible recipient's physical and behavioral health record. MAD services are subject to utilization review for medical necessity and program compliance. Reviews may be performed before or after services are...
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