HB 357 — MI VIA WAIVER PGM. PROVIDER GROSS RECEIPTS (Enacted)

Status: Signed into law (Act No. 227). Effective date: January 1, 2026. Introduced: Nov 12, 2024. Sponsor: Rep. Hollis.

Purpose / intent

To prevent gross receipts taxes (GRT) paid by providers from being counted against a Mi Via waiver participant’s individual budget allotment, and to require providers to bill those taxes separately so the Health Care Authority (HCA) reimburses GRT amounts in addition to the participant’s budget. The change aims to ensure Mi Via participants’ allotted budgets are not reduced by provider GRT charges.

Key provisions

• Rulemaking: HCA must promulgate rules to ensure GRT is excluded from calculations of Mi Via participants’ individual budgetary allotments.
• Separate billing and reimbursement: Providers’ costs for GRT must be billed as a distinct line item and reimbursed by HCA in addition to (i.e., outside of) the participant’s individual budgetary allotment.
• Definitions included:
  • “Individual budgetary allotment” — the total approved annual budget assigned to a Mi Via participant for services, supports and goods.
  • “Mi Via waiver program” — New Mexico’s self-directed Medicaid home- and community-based services waiver program.

Who is affected

• Mi Via waiver participants: Their individual budgets will no longer be reduced to cover provider-collected GRT amounts.
• Service providers participating in Mi Via: Must update billing to show GRT as a separate line item and submit those GRT charges to HCA for reimbursement.
• Health Care Authority: Responsible for rulemaking, reimbursing providers for billed GRT outside participant budgets, and administering the change.
• Taxation & Revenue Department (TRD): Continues to receive GRT remittances from providers; TRD may calculate distribution between state and local governments.
• Payers: Additional program payments will be made by HCA; part of these payments may be federal-matchable under Medicaid.

Fiscal and operational impacts

• New Mexico Legislative Finance Committee and HCA analyses indicate:
  • HCA program cost increase (Mi Via budget): approximately $25,654 in FY2026 (growing thereafter). Of that FY26 amount roughly $18,386 is expected to draw federal financial participation (FFP) and about $7,268 is state general fund.
  • Small one-time system/modification costs reported (~$62,500) for implementing billing changes.
  • LFC estimated recurring GRT remittances associated with the change in the low‑tens of millions to state and local governments (example: roughly $13.1 million to the general fund in FY26 in LFC tables), though actual revenue depends on vendor reporting and transaction volumes.
• The bill does not appropriate funds for HCA’s increased program costs; implementation will require administrative rulemaking and provider system updates.

Implementation / timeline

• Effective: January 1, 2026.
• HCA must adopt implementing rules and oversee provider compliance and reimbursement procedures before or on the effective date. Providers will need to modify billing systems to show GRT as a separate line item.

Summary: HB 357 ensures that providers’ gross receipts taxes are not charged against Mi Via participants’ individual budgets by requiring separate billing and HCA reimbursement, with modest implementation costs to HCA and providers and an associated shift in how GRT flows through program payments and tax remittances.