AGO 07-05.

• Case Date: September 12, 2007
• Court: New Mexico

New Mexico Attorney General Opinions 2007. AGO 07-05. September 12, 2007OPINION OFGARY K. KING Attorney General Opinion No. 07-05BY: Andrea R. BuzzardAssistant Attorney General TO: The Honorable Jeannette Wallace New Mexico State Representative 1913 SpruceLos Alamos, NM 87544QUESTIONS:

1. May Los Alamos County purchase individual health insurance policies for indigent patients using revenues from the county indigent hospital claims fund?

2. May Los Alamos County enroll indigent patients in the New Mexico State Coverage Insurance Program and, if so, pay the premium and co-payment amounts from either the county indigent hospital claims fund or from funds available pursuant to the Local Economic Development Act, NMSA 1978, §§ 5-10-1 to -13 (1993, as amended through 2003)?

3. May Los Alamos County contract with health care providers to provide services in advance of individual claims, such as reserving and paying for a given number of beds in an alcohol or drug rehabilitation center?

4. May Los Alamos County contribute monies from its county indigent hospital claims fund to those funds of other counties?

CONCLUSIONS: 1. No. Los Alamos County lacks the authority, either expressly or by necessary implication, under the Indigent Hospital and County Health Care Act to purchase individual health insurance policies for indigent patients using revenues from the county indigent hospital claims fund. 2. No. Los Alamos County does not have the statutory authority under the Indigent Hospital and County Health Care Act to enroll indigent patients in the State Coverage Insurance program and pay premiums and co-payment amounts from the county indigent fund. 3. Yes. Los Alamos County has authority under the Indigent Hospital and County Health Care Act to contract with health care providers to provide services associated with alcohol or drug abuse treatment, which could include bed reservation. 4. No. Los Alamos County does not have the necessary statutory authority under the Indigent Hospital and County Health Care Act to contribute, directly, monies from its county indigent hospital claims fund to those funds of other counties. However, nothing in the Indigent Hospital and County Health Care Act prohibits Los Alamos County from transferring money from its indigent fund to the sole community provider fund to match federal funds for the state medicaid program. Los Alamos County may, therefore, indirectly benefit other counties by utilizing the resources of its indigent fund to augment the funds necessary to match federal funds for the support of the state medicaid program. BACKGROUND: The purpose of the Indigent Hospital and County Health Care Act, NMSA 1978, §§ 27-5-1 to -18 (1965, as amended through 2004) is "to recognize that the individual county of this state is the responsible agency for ambulance transportation or the hospital care or the provision of health care to indigent patients domiciled in that county for at least three months. . . ." NMSA 1978, § 27-5-2 (A) (1997). The Act thus imposes a duty on each county to provide indigent health care for patients domiciled in that county and "provide[s] a means whereby each county can discharge this responsibility through a system of payments to ambulance providers, hospitals or health care providers for the care and treatment of, or the provision of health care services to, indigent patients." Id. The Act creates, within each county, a "county indigent hospital and county health care board," composed of members of the board of county commissioners. NMSA 1978, § 27-5-5 (1993). Generally, the duties of that board are to administer claims made pursuant to the Act, to adopt rules, to review all claims for compliance with board rules and with the Act, to approve or reject claims, and to pay claims that the board has approved. See id. The board is specifically allowed to "contract with ambulance providers, hospitals or health care providers for the provision of health care services. NMSA 1978, § 27-5-6(Q) (2003). The Act creates a procedure for payment of claims. Section 27-5-12 provides, in part:

A. A hospital, ambulance service or health care provider filing a claim with the board shall:

(1) file claim with the board of

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