New Mexico Medical Insurance Pool definition

New Mexico Medical Insurance Pool means the medical insurance pool created pursuant to XXXX 0000, 59A-54-1 et seq.

New Mexico Medical Insurance Pool means the medical insurance pool created pursuant to NMSA 1978, 59A-54-1 et seq. Non-Contract Provider means an individual Provider, clinic, group, association, or facility that provides Covered Services and that does not have a provider agreement with the CONTRACTOR. Non-Medicaid Contractor means an entity contracting with a State Agency to provide medical and Behavioral Health services with the use of non-Medicaid funds. Non-Quantitative Treatment Limitations (NQTLs) are limitations on benefits or services that are not expressed numerically, but otherwise limit the scope or duration of benefits. Not Otherwise Medicaid Eligible refers to individuals not eligible for Medicaid services under New Mexico’s Medicaid State Plan. Nursing Facility (NF) means a licensed Medicare/Medicaid facility certified in accordance with 42 C.F.R. part 483 to provide inpatient room, board, and nursing services to Members who require these services on a continuous basis, but who do not require hospital care or direct daily care from a physician. Nursing Facility Level of Care (NF LOC) means the Member's functional level is such that two (2) or more ADLs cannot be accomplished without consistent, ongoing, daily provision or assistance with prompting, of some or all of the following levels of service: skilled, intermediate or assisted. A Member must meet the NF LOC to be eligible for NF placement and community benefit services.

Examples of New Mexico Medical Insurance Pool in a sentence

• The Company is still required to participate in the New Mexico Medical Insurance Pool and will be assessed accordingly.

• Medicaid line of business Net Capitation Revenue: Earned capitation premium, excluding IHS supplemental revenue, less premium tax, less New Mexico Medical Insurance Pool (NMMIP) and NMHIX assessments during the annual period.

• Only the Board of Directors of the New Mexico Medical Insurance Pool or the Legislature of the State of New Mexico can approve a change to the Policy.

• CHP is a member of the New Mexico Medical Insurance Pool (NMMIP) and the New Mexico Health Insurance Alliance (NMHIA), which are risk pools for individuals who are unable to obtain health insurance on a voluntary basis.

• The nature of the task of the mystery client requires that he or she must be confident, accurate and reliable.

• The New Mexico Medical Insurance Pool (NMMIP), acting through its Board of Directors (Board), is soliciting information from potential bidders to conduct its annual financial audit.

• Medical/Surgical Claims - When covered services are received from non- participating providers who will not file the claim for you, mail the forms and itemized bills to: New Mexico Medical Insurance Pool AdministratorP.O. Box 1090 Great Bend, KS 67530 Prescription Drug - Claims for items covered under the prescription drug plan must be sent to the Pharmacy Benefit Manager - not to the Administrator.

• The New Mexico Medical Insurance Pool (Pool) was formed as an unincorporated not‐for‐profit entity by the New Mexico State Legislature in 1987.

• New Mexico already conducts some of the functions envisioned in an Exchange within the Insure NM! Call Center, New Mexico Health Insurance Alliance, New Mexico Medical Insurance Pool, and the Public Regulation Commission’s Division of Insurance.

• The New Mexico Medical Insurance PoolThe New Mexico Medical Insurance Pool (NMMIP) was established by the 1987 New Mexico State legislature.