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Quality Measurement and Reporting in New Mexico

        In order to enhance the quality of care provided within the state, New Mexico requires the health information system to collect information on the performance of health care providers in the state.1 The New Mexico Health Policy Commission must issue reports that contain performance measures in order to assist consumers in evaluating the quality of care and performance of health care providers.2

        A health maintenance organization (HMO) is required to have an ongoing quality assurance program to monitor and evaluate its health care services and must use a patient medical record system that allows care quality and care coordination to be assessed and monitored.3

 

Footnotes

  • 1. N.M.S.A. §24-14A-3
  • 2. N.M. Admin. Code 7.1.22
  • 3. N.M.S.A. §59A-46-7

 

Quality Measurement and Reporting in New Mexico

Subtopic Statute/Regulation Description
Grievance programs (Reporting requirements, Management of grievance reports) Consumer assistance; consumer advisory boards; ombudsman office; reports to consumers; superintendent's orders to protect consumers – N.M. Stat. Ann. §59A-57-5 New Mexico has adopted a Patient Protection Act.  The Act provides that all individuals enrolled in a managed care plan have the right to be...
Patient rights; disclosures; rights to basic and comprehensive health care services; grievance procedure; utilization review program; continuous quality program – N.M. Stat. Ann. §59A-57-4 New Mexico’s Patient Protection Act requires all managed care plans to have an adequately staffed consumer assistance office to respond to...
Quality Measurement and Reporting General Provisions-N.M. Code R. § 7.1.22.8 The New Mexico Health Policy Commission must issue a consumer health information reports in order to assist consumers in evaluating the quality of...
Health information system; creation; duties of commission – N.M. Stat. Ann. §24-14A-3 The state created a health information system to participate in the process of collecting, analyzing, and disseminating health information that would...
Investigatory powers-N.M. Stat. Ann. § 24-14A-4.2 The Department may inquire into the quality of the data submitted from all data sources. The Department may require the data source submit additional...
Quality Assurance-N.M. Code R. § 7.11.2.23 All facilities that provide outpatient medical services must conduct ongoing, comprehensive self-assessments. Such assessments must include the...
Quality Assurance-N.M. Code R. § 7.26.2.24 All intermediate care facilities must conduct on-going, comprehensive self-assessments to ensure quality services. Such an assessment must contain...
Quality Improvement-N.M. Code R. § 7.7.2.23 All hospitals must have a written quality improvement program that monitors and improves patients’ care. It is the responsibility of the Chief...
Performance measurement for health care providers or insurance plans HMO Quality Assurance – N.M. Stat. Ann. §59A-46-7 A health maintenance organization (HMO) must have procedures in place the ensure that enrollees receive quality care, including availability,...
Quality assurance programs for hospitals or public programs HMO Quality Assurance – N.M. Stat. Ann. §59A-46-7 A health maintenance organization (HMO) must have procedures in place the ensure that enrollees receive quality care, including availability,...
Reporting, Use and/or Confidentiality of quality data (Cross reference Privacy & Confidentiality) HMO Quality Assurance – N.M. Stat. Ann. §59A-46-7 A health maintenance organization (HMO) must have procedures in place the ensure that enrollees receive quality care, including availability,...