N.M. Admin. Code § 8.326.6.15

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.326.6.15 - PLAN OF CARE

A. Case managers develop and implement plans of care for each medicaid recipient. Plans of care are developed in consultation with the recipients, families or legal guardian(s), physicians and others involved with care.

B. The following must be contained in the plan of care or documents used in the development of the plan of care. The plan of care and all supporting documentation must be available for review in the recipient's file:

(1) statement of the nature of the specific problem and needs of the child;

(2) description of the intermediate and long-range goals with the projected timetable for their attainment, including specific information on the duration and scope of services; and

(3) statement and rationale of the plan of treatment for achieving these intermediate and long-range goals, including review and modification of the plan.

C. The plan of care must be retained by agency providers and be available for utilization review purposes. Plans of care must be updated and revised, as indicated, at least every six (6) months or more often, as indicated by the recipient's condition.

N.M. Admin. Code § 8.326.6.15

2/1/95; 5/15/96; 8.326.6.15 NMAC - Rn, 8 NMAC 4.MAD.775.6, 3/1/12