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New Mexico Proposes To Overhaul Medicaid Program

NM Department of Health

SANTA FE, N.M. (AP) —Gov. Susana Martinez's administration is proposing to overhaul a program that provides health care to a fourth of the state's population, and the changes could require some needy New Mexicans to dig into their pockets to pay a fee if they go to an emergency room for medical care that's not considered an emergency.

One of the goals of the planned revision is to slow the rate of growth in Medicaid, which accounts for 16 percent of this year's state budget and costs New Mexico taxpayers nearly $1 billion.

"We think it's a broken system. We think we need to change it now," Human Services Secretary Sidonie Squier said Tuesday in an interview in which she outlined the proposed revisions, which will require federal government approval.

She emphasized that there will be no cuts in enrollment or changes in who's eligible to receive medical services, and there will be no reduction in rates paid to health care providers.

However, the state proposes to require "co-pays" for Medicaid recipients who go to an emergency room for routine medical care and for using a brand name drug when a generic drug is available. The fee will be $3 for brand name drugs but won't apply to certain drugs used to treat mental health conditions. The fees for using an emergency room will vary according to a person's income, but could range from $6 to $50.

The state hopes to have the revamped Medicaid program implemented in October 2013. 

Copyright 2012 The Associated Press.  

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