1.Program Definition and Services
Non-Medical Transportation (NMT) Services in New Mexico provide essential mobility solutions to enable individuals with intellectual, developmental, or physical disabilities to access community activities, maintain employment, and utilize local resources.
- In-Home Personal Care: Ongoing planning and coordination within the individual’s natural environment (Comprehensive Personal Assessments, Care Planning, Resource Coordination, Independent Living Referrals, and Individual Advocacy)
- Residential Personal Care: Monitoring and interdisciplinary oversight within supported environments (Interdisciplinary Team [IDT] Coordination, Individualized Service Plan [ISP] Annual Development, Service Delivery Monitoring, Crisis Intervention Coordination, and Transition Support Management)
2. Regulations
The program is governed by the following regulations:
- New Mexico Administrative Code, Title 8, Chapter 314, Part 5 (Developmental Disabilities Home and Community-Based Services Waiver)
- New Mexico Administrative Code, Title 8, Chapter 314, Part 6 (Mi Via Home and Community-Based Services Waiver)
- New Mexico Health Care Authority (HCA) Developmental Disabilities Supports Division (DDSD) Waiver Service Standards (Non-Medical Transportation Provision Guidelines)
- Federal Highway Administration and New Mexico Department of Transportation (NMDOT) Vehicle Safety and Commercial Transit Passenger Regulations
3. Licensing or Certification
Providers must be certified by the New Mexico Health Care Authority (HCA) and the Developmental Disabilities Supports Division (DDSD), complying fully with federal Home and Community-Based Services (HCBS) guidelines. Because this program relies on physical transit vehicles, provider agencies must obtain appropriate operating authorities, commercial vehicle designations, or public transit permits through the New Mexico Motor Vehicle Division (MVD) and the New Mexico Regulation and Licensing Department (RLD).
4. Responsible State Agency
The New Mexico Health Care Authority (HCA), through its Medical Assistance Division and in coordination with the Department of Health (NMDOH) Developmental Disabilities Supports Division (DDSD) and the New Mexico Motor Vehicle Division, is responsible for evaluating applications, verifying fleet safety compliance, performing driver background checks, and certifying non-medical transportation services providers.
5. Application Process
The application process is conducted through the electronic New Mexico Medicaid Provider Enrollment Portal (YES.NM.GOV).
6. Required Documentation
While specific documentation requirements vary based on the target waiver, providers typically need to submit:
- Proof of compliance with state safety, vehicle maintenance, and transit operational rules
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Agency policies and procedures (including trip scheduling workflows, passenger securement protocols, fleet maintenance schedules, and accident/incident response workflows)
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Staff and driver qualifications, clean driving history printouts (MVRs), defensive driving certificates, and passenger assistance safety training records
- Proof of commercial general liability, professional administrative liability, and specialized commercial auto insurance providing a minimum of $1,000,000 in combined single limit coverage naming the State of New Mexico Health Care Authority as an additional insured
7. Timeline for Approval
The exact timeline for approval fluctuates based on agency capacity. The provider enrollment application review and vehicle safety validation process typically takes approximately 60 to 90 days once a complete packet is submitted.
8. Pre-Application Process
Prospective providers must complete specific foundation tasks before applying. They must establish their business entity with the New Mexico Secretary of State, secure necessary federal identification numbers (such as an EIN and an applicable Type 2 NPI), pass preliminary multi-point safety inspections on all operational fleet vehicles, and establish a digital account on the state provider portal.
9. Pre-Application Training
The state hosts mandatory administrative and transit compliance training sessions online. Access details are sent to qualified applicants once preliminary driver and agency documentation is reviewed through the state's provider learning management system.
10. Additional Notes
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Case management agencies are subject to ongoing regulatory oversight and unannounced field audits conducted by the Quality Management Bureau (QMB) to verify compliance with CMS waiver assurances
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If a QMB survey uncovers programmatic deficiencies, the agency must submit a formal Plan of Correction (POC) within 10 working days and fully implement the changes within 45 days
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All case managers, support coordinators, and administrative leadership must complete mandatory background clearances via the New Mexico Caregivers Criminal History Screening (CCHS) program.
- Case managers must maintain meticulously organized files detailing face-to-face participant visits, annual level-of-care recertifications, ISP revisions, and explicit communication logs with community service vendors
Why Choose Waiver Consulting Group?
Starting or expanding your Medicaid waiver-funded agency can feel overwhelming, but it doesn't have to be. At Waiver Consulting Group, we simplify the process by guiding you through licensing, compliance, provider enrollment, policies & procedures, and regulatory approvals in any state.
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