PROVIDERS
The Health Care Authority’s mission is: We ensure that New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services.
Indian Health Service, Tribal 638 and Urban Indian Health Programs (I/T/Us)
Continuing Care as an I/T/U Provider
Native Americans will be able to seek care from Indian Health Service, Trubal 638 and Urban Health Programs (I/T/U), regardless of whether the I.H.S. and Tribal 638 providers contract with the managed care organizations (MCOs). I/T/U providers will be paid the Office of Management and Budget (OMB) rates (the federal rate).
The MCOs are required to make their best efforts to contract with the I/T/Us. However, no I/T/U provider will be forced to contract with an MCO. If an I/T/U provider decides NOT to contract with the MCO, Native Americans may still access I/T/Us and the provider is still paid the OMB rate for services.
The MCOs have a contractual requirement to make prompt and accurate payments to all providers, including the I/T/Us. The MCOs are required to work closely with the I/T/Us to train all providers on filing a clean claim to speed processing of payments.
I/T/U Benefits for Joining an MCO
As an “in network” provider under an MCO in Centennial Care, patients will have access to expanded care coordination, and specialty providers within the MCO network. This allows I/T/Us to provide better management of limited resources thereby stretching contract health dollars for use of other Tribal members.