New Mexico Medicaid Waivers & Home and Community Based Programs Overview

New Mexico, known as The Land of Enchantment, has a well-structured Medicaid Waiver and Home and Community-Based Services (HCBS) system designed to provide long-term care alternatives for seniors, individuals with disabilities, and those with chronic health conditions.

Administered by the New Mexico Human Services Department (HSD), Medical Assistance Division (MAD), and the New Mexico Department of Health (DOH), Developmental Disabilities Supports Division (DDSD), the state’s Medicaid waiver programs allow eligible individuals to receive services in their homes or community settings rather than institutional care.

Key waiver programs include the Community Benefit (CB) under Centennial Care 2.0, which provides personal care, respite, and home modifications for seniors and individuals with physical disabilities, and the Developmental Disabilities (DD) Waiver, which offers habilitation, behavioral health, and employment support for individuals with intellectual and developmental disabilities (IDD).

Additional programs include the Mi Via Self-Directed Waiver, which gives participants control over their care and service providers, the Medically Fragile Waiver, which serves individuals with complex medical needs, and the Supports Waiver, which provides services for individuals with IDD who do not meet the level of care required for the DD Waiver.

Regulatory oversight in New Mexico is managed through HSD, MAD, and DDSD, with additional provider licensing and compliance enforcement by the New Mexico Department of Health (DOH), Division of Health Improvement (DHI). The state operates under a Managed Care model, with Medicaid waiver services coordinated through Centennial Care’s Managed Care Organizations (MCOs) to enhance service delivery and cost-effectiveness.

New Mexico has also implemented Electronic Visit Verification (EVV) for personal care services, ensuring greater accountability and fraud prevention in home-based care programs. Providers must navigate Medicaid enrollment, prior authorization processes, and compliance requirements to participate successfully in the state’s HCBS programs.

With a strong emphasis on self-direction, rural healthcare access, and culturally competent services for Native American and Hispanic populations, New Mexico’s Medicaid waiver system ensures that individuals receive high-quality, community-based supports while promoting independence, dignity, and inclusion in their local communities.

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Explore Policy and Procedure manual for licensing and certification for your state Medicaid Waiver and HCBS programs here.

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