KodaComplyHome care rules, state by state, in plain EnglishDocuments collected September 22, 2026

New Mexico home care rules

New Mexico's Health Care Authority (HCA) licenses home health agencies, but its rule does not cover businesses that give only non-medically directed care in the home. Medicaid personal care is paid through four Turquoise Care health plans: Blue Cross and Blue Shield of New Mexico, Molina, Presbyterian and UnitedHealthcare. Since May 20, 2026, agencies serving health plan members may send EVV visits from their own vendor through an aggregator instead of using AuthentiCare.

69 official documents·collected September 22, 2026·checked against them September 23, 2026
License for non-medical home care?No, if care is not medically directedHCA's home health rule excludes businesses giving only non-medically directed care. Personal care or homemaker services given under a plan or level of care that a physician reviews and approves at least once a year count as medically directed and need a home health agency license.
License for home health?YesHome health agency license from HCA under 8.370.22 NMAC. The license is annual, and the fee is $300 for each initial or renewal application.
EVVRequiredRequired for Medicaid personal care, respite and home health. You can use AuthentiCare at no cost, or pay for your own vendor that sends visits through the aggregator (since May 20, 2026 for health plan members; since September 30, 2025 for fee-for-service).
Medicaid health plans4 plansBlue Cross and Blue Shield of New Mexico, Molina Healthcare, Presbyterian Health Plan, UnitedHealthcare (Turquoise Care)

What changed, and what to do about it

Red means act now, amber means read it this month, grey is for the record.

Read this monthLetter of Direction 59-1, June 30, 2026

Personal care rates up 5.8% from July 1, 2026

The 2026 legislature funded a 5.8% increase for Community Benefit personal care. HCA raised its recommended rates for 99509 and T1019 by 5.8%, effective July 1, 2026. It told the health plans to reprocess claims no later than September 1, 2026. Plans that pay below the recommended rates must tell HCA.

What to do: Compare your July and August payments from each health plan with the new rates. Ask your plan's provider representative about any claims that weren't reprocessed.
Read this monthOpen system for health plans from May 20, 2026

You can now use your own EVV vendor for health plan members

New Mexico's EVV is now an open (hybrid) system. Agencies can keep using AuthentiCare at no cost, or pay for another vendor that sends visits through the AuthentiCare Data Aggregator. Switching is optional. Conduent must approve your declaration and attestation forms before testing.

What to do: If you are staying with AuthentiCare, you don't need to do anything. If you want to switch, email Conduent for the forms first.
Read this monthLetter of Direction 65 · for incidents on or after October 31, 2025

Critical incident reporting narrowed

Emergency services, law enforcement and environmental hazard incidents no longer go to the HCA MAD Critical Incident Portal unless they involve abuse, neglect, exploitation, misuse of restraints or seclusion, or a provider's medication error that leads to a poison control call, an emergency room or urgent care visit, a hospital stay or death. Insufficient staffing is reportable only in narrow cases. Agencies report within 24 business hours.

What to do: Update your incident policy and retrain the staff who file reports. Keep reporting abuse, neglect and exploitation to APS.
For the recordRevision dated August 11, 2026

Managed Care Policy Manual updated

HCA posted an updated Turquoise Care Managed Care Policy Manual (its web address says "Effective August 11, 2026"). Section 4 (Care Coordination) and Section 8, which holds the personal care agency and attendant requirements, show August 11, 2026 revision dates. The documents don't say what changed.

What to do: Download the current Section 8 and read the personal care part before your next health plan audit.

Deadlines coming up

Dates taken from the rules and notices as we read them.

99days
December 31, 2026

Health plans' annual personal care newsletter due

Letter of Direction 25 (October 2024) tells the plans to send their contracted personal care providers an HCA-approved newsletter by December 31 each year.

1195days
December 31, 2029

Turquoise Care 1115 demonstration approval ends

CMS approved the demonstration extension from July 25, 2024 through December 31, 2029.