State adds 16 new benefit and delivery system changes to better serve New Mexicans, and introduces Turquoise Care as the new name for the Medicaid Program

SANTA FE – The New Mexico Human Services Department today announced they have submitted a five-year renewal application for the state’s Medicaid program to the U.S. Centers for Medicare & Medicaid Services (CMS) under the new Medicaid name Turquoise Care. The renewal application is for an effective date of January 1, 2024, through December 31, 2028.

New Mexico operates its Medicaid program under a federal 1115 demonstration waiver authorized by CMS. Federal 1115 demonstration waivers give states flexibility to design experimental, pilot, or demonstration projects that assist in promoting the objectives of the Medicaid program and use state-specific policy approaches to better serve Medicaid populations. This waiver will serve all New Mexico Medicaid members but has targeted interventions to address the populations suffering from the greatest health disparities.

The state’s Medicaid 1115 demonstration waiver is set to expire on December 31, 2023, and the state is required to submit a renewal application to CMS twelve months prior to expiration.

“We serve forty seven percent of the state’s population through the Medicaid program,” said David R. Scrase, M.D., cabinet secretary for the New Mexico Human Services Department. “This renewal seeks to simplify and improve member experience, with the ultimate goal of achieving improved health outcomes and well-being for the 980,931 New Mexicans currently on Medicaid.”

“The only way we will see positive outcomes is to transform the way we deliver care to New Mexicans who experience significant health disparities — parents and children, children in the child welfare system, elders, New Mexicans with multiple chronic conditions, people experiencing serious mental illness or substance use disorders, individuals experiencing homelessness and housing insecurity, and returning citizens with experience in the justice system,” said Nicole Comeaux, JD, MPH, Director of the New Mexico Medicaid Program. “This is a population health-based waiver that identifies these key groups and drives the New Mexico Medicaid program toward whole person care – a program that addresses not only physical and behavioral health needs, but also the social determinants, like housing and food, that so greatly impact our health and well-being.”

Since 2019, the Medicaid program has worked to improve program benefits, provider payments, and access to care. Under Gov. Michelle Lujan Grisham’s leadership, HSD has invested over $800 million in increased provider rates, extended postpartum coverage to 12 months, worked to eliminate the developmentally disabled waitlist for services, removed asset tests that create barriers for older adults, implemented home visiting programs for pregnant people, processed 6,534 Medicaid provider enrollment applications and added reimbursement of Adult Accredited Residential Treatment Center services. 

Initiatives in the renewal application include, but are not limited to:

• Ensuring New Mexican children have continuous Medicaid coverage up to age six.
• Expanding access to home visiting programs to help families achieve healthy pregnancies and babies.
• Providing housing support following an inpatient or emergency visit.
• Expanding access to supportive housing providing safe and stable housing to individuals more at-risk of adverse health outcomes.
• Expanding access to home delivered meals to meet nutrition needs.
• Providing Medicaid coverage to justice involved individuals 30 days prior to release.
• Expanding Home and Community Based (HCBS) Community Benefit enrollment opportunities through additional waiver slots to help more New Mexicans maintain independence and personal choice.
• Investing in a statewide system that connects healthcare providers and community organizations that supports health equity by improving access to care.
• Creating a first of its kind, member-directed traditional healing benefit for Native American communities.

To access materials on the Medicaid 1115 demonstration waiver renewal and Turquoise Care, click here.

HSD will publish its final application to the HSD website following CMS confirmation of completeness.

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The department wants to ensure our clients of uninterrupted access to the benefits available to them. The easiest way to do this is to make sure contact information is up to date on the YESNM Portal: www.yes.state.nm.us. Users can simply and easily update their address using the chat functionality there. Step-by-step directions on how to update your address are available here. Individuals seeking to apply for or check their SNAP benefits may apply online through www.yes.state.nm.us or by phone at 1-800-283-4465

We talk, interpret, and smile in all languages. We provide written information to our customers in both English and Spanish, and interpretation services are available in 58 languages through our provider, CTS Language Link. For our hearing, and speech impaired customers, we utilize Relay New Mexico, a free 24-hour service that ensures equal communication access via the telephone to individuals who are deaf, hard of hearing, deaf-blind or speech disabled. The Human Services Department provides services and benefits to 1,088,981 New Mexicans through several programs including: the Medicaid Program, Temporary Assistance for Needy Families (TANF) Program, Supplemental Nutrition Assistance Program (SNAP), Child Support Program, and several Behavioral Health Services.