New Mexico § 27-2-45 - Hospitals; claims for payment

§ 27-2-45. Hospitals; claims for payment

A. A hospital may submit eligible claims to the department on or before April 1 of

each year for payment from the fund by June 30 of each year in an amount determined

pursuant to this section. B. A claim submitted by a hospital for payment from the fund shall be deemed an eligible

claim if it is for: (1) uncovered hospital charges of five thousand dollars ($5,000) or more for an illness

of a medically indigent patient; (2) hospital charges incurred within the twelve months immediately prior to the applicable

April 1 closing deadline; and (3) an amount determined by subtracting from the base claim the medically indigent

patient's deductible and then reducing the resulting balance, based on the hospital's

medicare cost-to-charge ratio, to an amount equal to medicare allowable costs. C. The department shall pay from the fund to each hospital the amount of each eligible

claim if there is sufficient money in the fund. If there is not sufficient money in the fund to pay all eligible claims of hospitals

for that year, the amount of each claim that shall be paid shall be an amount derived

from multiplying the full amount of the eligible claim by the percentage derived from

dividing the balance in the fund, after administrative costs have been subtracted,

by the sum of the eligible claims.