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The New Mexico Medical Society has worked hard over the years to bring benefit
to your medical practice. Some of these benefits are described on protected pages and for NMMS
members only. Contact NMMS or Clare Thompson cthompson@nmms.org for username and password. Click below for more on each and for practice info in general.
- AMA Model
Managed Care Contract
 updated June 2005
- American Physicians
Assurance Corp. - malpractice insurance. Recommended
by NMMS
- Closing Your Practice - A Guide For Physicians -
Closing a practice takes time and planning. There are legal,
ethical, and medical considerations. Patients and employees, along with
organizations such as the medical boards, hospitals, and managed care
organizations need to be notified. There are issues related to medical
records release and retention. Accounts payable and accounts
receivable, malpractice insurance, and administrative issues must all
be addressed. The attached file addresses these issues and includes
forms which we hope you will find helpful.
- CMS Enhances Program
Integrity Efforts to Fight Fraud, Waste and Abuse in
Medicare - CMS is working closer with beneficiaries and providers; consolidating
its fraud detection efforts; strengthening its oversight of medical equipment
suppliers and home health agencies; and launching the national Recovery Audit
Contractor (RAC) program.The new national RACs can be found at: http://www.cms.hhs.gov/RAC/Downloads/RAC%20Expansion%20Schedule%20Web.pdf. Visit the CMS RAC
Web site for more information. The CMS press release issued October 6, 2008, and
the RAC fact sheet are also available.http://www.cms.hhs.gov/RAC/
- Complaints
- Some years ago, NMMS' Managed Care Committee adopted a process by
which to file payer complaints, both for commerical and Salud!
patients. Click here for the form. We will forward it to the correct
medical director for action. The AMA has a similar program on the national level.
- Coordinated Long Term Services (CLTS)....is a new Medicaid managed care
program provides and coordinate services for specific Medicaid recipients. Information on the program. HSD is holding informational
events around the state.
- Credentialing
- Application for physician/practitioner appointment download PDF
file
This form was developed in 1996 by the New Mexico Medical Society
and The New Mexico Hospitals and Health Systems Association, in a joint effort
to offer providers a tool that possesses the flexibility to accommodate the
unique needs of all integrated health care systems. The statewide application
is available to all entities requiring credentials verifications, such as
IPA's, HMO's, PPO's, MCO's, as well as hospitals and other health care facilities.
If you or your organization is interested in utilizing The New Mexico Statewide
Application For Physician/Practitioner Appointment©, you may download
the application form as a Microsoft Word document from this website.
-
Criminal Background Check Now Required for Physicians
Effective July 1, 2007, the New Mexico Medical Board began
requiring all applicants for initial licensure and reinstatements to
submit fingerprints for a state and national criminal background check.
More information.
Health Services Corporation (HSC), a partner of NMMS in many projects, can do this for you at your office or theirs.
Call 343-0070 or email: fingerprinting@nmhsc.com
- See what NMMS has compiled regarding HIPAA, the Health Insurance
Portability and Accountability Act of 1996 (HIPAA) - more federal
regulations to implement! Click here.
- Medicare Bonuses - Did you know that Medicare pays up to a 15% bonus, automatically for services performed in certain zip codes?
- Medicare Part D
- Physician Information
- The Medicine
Program - assistance with enrollment in "Patient Assistance Programs"
that provide free prescription medicines to those who qualify - Application
form available on website
- Medicaid Reimbursement Info
Governor Bill Richardson signed a 2006-2007 state budget that included
a huge increase to physicians for their Medicaid services. With the
federal match, the increase amounts to more than $33,000,000. In
addition, all health care providers, including physicians, will receive
another 1.5% increase, intended to restore the cut of 1.5% that was
made in 2004. Click
here to see the fee schedule...
- Patient Records - The New Mexico Medical Board has set an amount for doctors to charge for
medical records: $15 for the first 15 pages, thereafter $.10 per page. The
board has also specified how long medical records need to be retained. Click here to read the entire
regulation, 16.10.17. Please contact your attorney and/or malpractice insurance carrier if you
have specific questions about the retention of medical
records under your malpractice
policy.
- Physician Survey -
The Health Policy Commission contracted with the Center for Health
Workforce Studies of the State University of New York to do a follow up
survey to the 2002 survey of New Mexico's physicians. The report
presents an overview on the supply and distribution of physicians
practicing in New Mexico as well as issues of interest to physicians.
It is designed to help planners, policy makers and the public make
informed decisions about the adequacy of the physician workforce in
their communities, regions and state. Read...
- Reportable Conditions...as required by state government. New
Mexico health care providers are required to report certain suspect or
confirmed conditions to the Department of Health.
- Silent PPOs Information for physicians about "renting" your discount fees and the "presumed" plan participation in
Medicare Advantage plans.
- Tamper Resistent Scripts...Written prescriptions in the Medicaid program must
have one feature to prevent unauthorized copying, another to prevent erasure or
modification of information and a third to prevent counterfeiting. EXEMPT FROM
THE LAW: prescriptions paid for by Medicaid managed care plans; nursing homes
and other institutions; electronic,
faxed or phoned prescriptions.
Prescriptions MUST contain your NPI. More.
- Taxes: GRT
NMMS’
legislation that provides a gross receipts deduction for physicians on
their contracted medical services took effect January 1, 2005.
New Mexico Department of Taxation and Revenue “FYI”, click here.
NMMS
has worked long and hard to fix the problem of gross receipts on
medical services. In 1998 we were successful in passing legislation
that allowed physicians to deduct the gross receipts tax from services
provided to Medicare Part B. That legislation was extended to services
to TriCare patients. In the 2004 session, NMMS was able to pass a
deduction for physician contracted services and services under Medicare
Part C. In 2007, receipts from MORE services, and a TAX CREDIT were
added to the GRT law. You will need to apply for the credit, and IT IS
RETROACTIVE. Click here for instructions and form. Click here for our updated physician information GRT packet. Click
here for FAQs. You may also call or email the Tax and Revenue Dept. directly with questions: (505)
827-0908 poffice@state.nm.us.
The GRT still applies to co-pays, patient deductibles and
certain other receipts. Here is information on calculating if applicable.
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