New Mexico § 52-4-3 - Case management

§ 52-4-3. Case management

A. The director shall establish a system of case management for coordinating the health

care services provided to workers claiming benefits under the Workers' Compensation

Act or the New Mexico Occupational Disease Disablement Law. B. As used in this section, “case management” means the ongoing coordination of health

care services provided to an injured or disabled worker, including but not limited

to: (1) developing a treatment plan to provide appropriate health care services to an

injured or disabled worker; (2) systematically monitoring the treatment rendered and the medical progress of the

injured or disabled worker; (3) assessing whether alternate health care services are appropriate and delivered

in a cost-effective manner based on acceptable medical standards; (4) ensuring that the injured or disabled worker is following the prescribed health

care plan; and (5) formulating a plan for return to work. C. The director shall contract with an independent organization to assist with the

administration of the provisions of this section. D. Nothing in this section shall prevent an employer from establishing his own program

of case management; however, for the purposes of resolving choice of health care

provider disputes, an employer or worker shall only use the program as provided by

the workers' compensation administration, as set forth in Section 52-1-49 NMSA 1978 .