New Mexico
LLC
Website link to register:
https://portal.sos.state.nm.us/BFS/online/
Naming conventions
Restricted words require approval; must indicate the professional service for PLLCs. Must include “Limited Liability Company,” “LLC,” or “L.L.C.” Professional services must use “PLLC.”
Licensing Requirements
Licenses are issued and verified by the New Mexico Medical Board. Malpractice insurance mandatory. Additional permits for telemedicine may apply.
Required documentation for medical practices
Articles of Organization, New York State Health Permits, Malpractice Insurance, Professional Licenses
Filing Fee: $50
Annual/Biennial Fee: None
Additional Notes: No annual report or renewal fees required for LLCs.
Medicaid
Program Name: Centennial Care
Official Website: https://www.hca.nm.gov/lookingforassistance/#et-main-area
Legislation: New Mexico does not have specific DPC legislation; practices operate under general healthcare and insurance laws.
Private Contracting
Permitted; DPC practices should ensure compliance with state insurance regulations to avoid being classified as insurers.
Restrictions
No explicit restrictions for DPC providers; compliance with federal and state regulations is necessary.
Medicaid Program
New Mexico Medicaid, known as Centennial Care, provides health coverage to eligible low-income residents.
Notification Requirements
Notification strongly recommended for Medicaid patient clarity.
Provider Enrollment Requirements
Providers must enroll with Centennial Care to serve beneficiaries directly or offer reimbursable services.
Enrollment Options
No "Ordering and Referring Only" status available.
Ordering, Referrals, and Testing
Non-enrolled providers may face challenges with Medicaid recognition for orders and referrals.
Designated PCP Restrictions
DPC physicians cannot act as Medicaid-designated PCPs.
Billing and Reimbursement
DPC practices typically do not bill Medicaid for services covered under private agreements.
Managed Care Plan Exemptions
Not specified.
Billing Clarity
Cannot bill Medicaid patients for covered services unless explicitly outlined.
CMS Guidance
CMS encourages streamlined enrollment for non-billing providers.
Opportunities for Collaboration
Opportunities may exist to collaborate with Medicaid Managed Care Organizations (MCOs) or state initiatives aimed at improving access to care.
State-Specific Notes
Collaboration opportunities exist with New Mexico Medicaid Managed Care Organizations for primary care expansion.
Dispensing Medication
Board of Pharmacy Official Link: http://www.rld.state.nm.us/boards/Pharmacy.aspx
State Licensing
Physicians must register with the New Mexico Board of Pharmacy to dispense controlled substances.
Scope of Practice
Dispensing is allowed within a physician’s scope of practice; controlled substances require additional DEA registration.
Inventory Management
Maintain detailed inventory logs and secure storage for all medications.
Record-Keeping
Records must adhere to New Mexico state laws and federal HIPAA regulations.
Dispensing Standards
Labels must include patient name, dosage, prescribing physician, and instructions for use.
Controlled Substances
DEA registration and reporting to New Mexico’s PMP are mandatory for controlled substances.
Billing and Reimbursement
Billing practices must adhere to New Mexico and federal anti-kickback statutes.
Federal Compliance
Physicians must comply with federal DEA, FDA, and New Mexico-specific regulations.
State Pharmacy Laws
Registration with the New Mexico Board of Pharmacy is required for controlled substances dispensing.
Patient Consent
Patient consent must be obtained before dispensing medications.
Insurance and Liability
Physicians must ensure their malpractice insurance includes coverage for dispensing.
Training Requirements
Continuing education is encouraged for physicians dispensing controlled substances in New Mexico.
Audits and Inspections
Inspections by the New Mexico Board of Pharmacy ensure compliance, with penalties for violations.