New Mexico Medicaid

Effective July 1, 2024, the New Mexico Human Services Department (HSD) has become the New Mexico Health Care Authority (HCA). This HCA integrates HSD, the Employee Benefits Bureau from the General Services Department, and the Division of Health Improvement and Developmental Disabilities Supports Division from the Department of Health and will work to expand access to care in rural communities, build a robust behavioral health system, and administer income and child support programs to combat poverty and food insecurity. Comagine Health is working on updating our documentation with the new name, which should be completed shortly. For more information about the New Mexico Health Care Authority and its mission, please visit the HCA website.

Please be advised that due to a recent system update, the number of days entered for annual episodes should now be 364, not 365 as previously indicated.
Key Changes:

• Instructional Videos: The training videos on the Providers page will still show 365 days, but please enter 364 days.
• Documentation Updated: Process documents and quick start guides have been updated to reflect this change.

Please review the updated guides and make the necessary adjustments to your episode entries in the future, there is no need to correct existing episodes. For questions or assistance, contact our support team.

To enhance the privacy and security of our members’ Personal Health Information (PHI), we are implementing a necessary update to the way providers access member records within our system. Starting mid-May 2024, access to members’ records using the “9NM” identifier will be refined to limit PHI exposure and ensure that providers only access information on an as-needed basis.

For providers, this update means a slight adjustment in how member records are accessed. This change mandates that providers use a specific identifier, “9NM + Medicaid Provider ID” (e.g., 9NM000X1234) when searching for member information. This update is important for maintaining the highest standards of privacy and security for the New Mexico Medicaid members’ information and complies with our ongoing commitment to safeguard PHI.

Comagine Health is upgrading our current Comagine Health Provider Portal (CHPP) Jiva system. The upgraded system will be implemented on June 5, 2023.

All fee-for-service (FFS) providers rendering services that require a prior authorization or level of care (LOC), and all Home and Community-Based Waiver case managers, consultants, and community supports coordinators are required to enroll in an updated training presentation of the upgraded CHPP system. The training presentation will demonstrate how to submit prior authorization, budgets and level of care requests in the upgraded system. Providers will also retrieve prior authorization, approved budgets and level of care correspondence documents through the upgraded CHPP.

All Comagine Health Provider Portal users must be registered for the training presentation by Monday, May 1, 2023. Comagine Health Provider Portal users are required to register for the appropriate training by utilizing the registration links below.

Recordings of the trainings are available on the Comagine Health website Provider page under the Comagine Health Provider Portal section.

• Acute Psychiatric Care in Freestanding Psychiatric Hospital
  May 15, 2023
• Contact Lens
  May 19, 2023
• Dental
  May 17, 2023
• Developmentally Disabled Waiver Case Managers
  May 16, 2023
• Durable Medical Equipment (DME) to include Prosthetics/Orthotics and Nutritional Services
  May 19, 2023
• Early and Periodic Screening Diagnostic and Treatment (EPSDT)
  May 22, 2023
• Hearing Aids
  May 19, 2023
• Home Health
  May 18, 2023
• Hospitals/Physicians
  May 23, 2023
• Intermediate Care Facilities (ICF/IID)
  May 17, 2023
• Medically Fragile Waiver Case Managers
  May 16, 2023
• Mi Via Waiver Consultants
  May 16, 2023
• Nursing Facilities (NF)
  May 17, 2023
• Private Duty Nursing Service
  May 22, 2023
• Program of All-Inclusive Care for the Elderly (PACE)
  May 15, 2023
• Rehabilitation Services (In/Outpatient)
  May 15, 2023
• Residential Accredited and Residential Non-Accredited Behavioral Health
  May 18, 2023
• Residential Substance Use Disorder (SUD) Treatment
  May 15, 2023
• Supports Waiver — Agency-Based Community Support Coordinators
  May 16, 2023
• Supports Waiver — Participant-Directed Community Support Coordinators
  May 16, 2023
• Therapies
  May 18, 2023
• Transplant Services (In-State)
  May 23, 2023
• Treatment Foster Care
  May 18, 2023T
• UNM Outsider Reviewer
  May 22, 2023

The website provides access and information to:

• The Comagine Health Provider Portal registration packet
• Available training dates by provider type
• Quick start guides and training videos with step-by-step instructions on how to successfully submit a request or retrieve correspondence documents
• Frequently Asked Questions

Onsite training may also be requested for your agency/facility by contacting Kimberley Scott, Comagine Health, at 1-888-962-2180. Technical assistance is available by contacting Comagine Health at 1-866-962-2180. It is highly recommended that providers utilize the resources available on the website prior to calling for technical assistance.