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New Mexico: Rules for payments for health care services could change
The Workers' Compensation Administration proposed amendments to rules regarding payments for health care services and the health care providers' fee schedule.
The proposal includes new procedures for the authorization of outpatient and inpatient services. Outpatient services must be approved or denied by the insurer within three business days, or the request will be deemed authorized. Inpatient services must be approved or denied by the insurer within 24 hours, or it will be deemed authorized. The proposed rule also states that durable medical equipment shall be preauthorized by the payer within 72 hours unless the worker is hospitalized at the time of the request, in which case authorization must be granted or denied within 24 hours. The rule and fee schedule will become effective Dec. 31. To view full text of the proposed rule and a list of changes to the fee schedule, visit www.workerscomp.state.nm.us/. Read more at the WorkersComp Forum homepage.
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