Options for terminally ill patients in New Mexico
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Explains care options available to terminally ill individuals in New Mexico, including hospice care and that since 2021 the state allows Medical Aid in Dying; intended for members and provider care teams interacting with Presbyterian Health Plan members in New Mexico.
No material clinical or coverage changes in this revision.
Coverage Criteria and Scope
This document is informational and does not specify coverage criteria or explicit exclusions. It explains care options available to terminally ill individuals in New Mexico, including hospice care and the option of Medical Aid in Dying, and is intended to inform members and provider care teams interacting with Presbyterian Health Plan members in New Mexico.
Provider Responsibilities and Authorization
Prior authorization — none specified
No prior authorization requirements are specified in this document for hospice services or Medical Aid in Dying; the document is informational about options available to terminally ill patients in New Mexico.
Document-level provider action — informational only
This informational policy does not impose any specific provider obligations for authorization, billing, or clinical steps beyond communicating options; treat the document as descriptive of available options rather than authorization criteria.
Inform patients about Medical Aid in Dying
Providers should inform terminally ill patients in New Mexico that Medical Aid in Dying is an available option and may discuss it with patients, family, spiritual advisors, or other care team members.
- State requires that information on Medical Aid in Dying be provided as an option for those who are terminally ill.
- Refer patients to NM End of Life Coalition (endoflifeoptionsNM.org), American Clinicians Academy on Medical Aid in Dying (acamaid.org), or discuss with the patient’s medical provider or care team.
Information does not trigger billing/authorization
Informational content and the requirement to provide information about Medical Aid in Dying do not by themselves create billing, prior authorization, or denial triggers; the document describes options and supportive services rather than coverage rules.
Background on Care Options
Hospice care is described as supportive care that does not hasten death but instead provides reassurance and comfort, aiming to reduce suffering and anxiety during the natural dying process. Hospice professionals focus on addressing the patient’s physical, psychosocial, and spiritual needs and supporting both the patient and their loved ones. The document also notes that since 2021 New Mexico permits Medical Aid in Dying — defined as the self-administration of medications that end life — and that the state requires information about this option be provided to terminally ill individuals.
Key Definitions
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