Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO | Summer 2022 | Your Story

Presbyterian Health Plan, Inc. P.O. Box 27489 Albuquerque, NM 87125-7489 www.phs.org Important plan information Standard U.S. Postage PAID Presbyterian Health Plan MC Summer 2022 Yourstory INSIDE $0 telehealth benefit for 2022 8 Try these tips for healthy aging 9 for Presbyterian Senior Care (HMO/HMO-POS), Presbyterian MediCare PPO, and Presbyterian Dual Plus (HMO D-SNP) members If you plan to travel this year, you can help keep your family and friends safe by testing yourself for COVID-19 before you go. COVID-19 self-tests, also called home tests, can be taken anywhere and anytime. You don’t need to have symptoms to perform a test. Some self-tests use a swab of saliva from your mouth. Others use a sample of mucus from your nose. The great part about self-tests is that they provide rapid results that can help you determine if it is safe to see others, especially if the get-together includes children too young to be vaccinated or people who are at high risk for severe illness. If you have symptoms of COVID-19 or you’ve spent time with someone who has COVID-19, it is important to perform a COVID-19 test. In this case, the U.S. Food and Drug Administration (FDA) recommends asking your doctor for advice. They might recommend or prescribe a specific test. How to get your test Choose an authorized test. Check the FDA’s list of tests with current emergency use authorizations. (Go to www.fda.gov and search for “tests for SARS-CoV-2.”) Also, make sure the test is intended for your age group. Look for a diagnostic test. According to the FDA, diagnostic tests can show if you currently have COVID-19. They include molecular and antigen tests. Antibody tests look at whether your immune system has reacted to the coronavirus. But that response can take days or weeks to develop. Don’t use antibody tests to find out if you currently have COVID-19. Buy directly at a pharmacy, retail store, or online. You can also check with your local health department about getting a test for free. If you have COVID-19 symptoms or you’ve been near someone who has COVID-19, ask your doctor if you need a prescription test. How to use your COVID-19 test When you test yourself for COVID-19, it’s important to follow instructions carefully. If you don’t collect your sample correctly, the test may not be as accurate. Read the instructions in your test kit before you start. And get prepped for the test with these tips from the Centers for Disease Control and Prevention (CDC): ● Have a timer ready on your phone, or use a kitchen timer ● Disinfect the surface where you will open the test kit ● Wash your hands with soap and water for at least 20 seconds —Continued on page 2 How to test yourself for COVID-19

2 Elder abuse: Know the facts Sadly, elder abuse is common in the United States. About one in 10 people ages 60 and older who live at home experience some kind of abuse. It can take place anywhere, and the abuser can be a spouse, an adult child, a caregiver, or a friend. Elder abuse can take many forms. It can be: Physical abuse. This includes hitting, pushing, and slapping. Restraining an older adult against their will is also abuse. Emotional abuse. Yelling at, threatening, or ignoring an older adult is emotional abuse. So is isolating them from friends and relatives. Neglect. This is the failure to meet an older adult’s basic needs, such as food, water, clothing, hygiene, and medical care. Financial abuse. This happens when money or belongings are taken from someone. It can include stealing Social Security benefits or using credit cards without permission. Abandonment. This is leaving the older adult alone without a plan for their care. Any older adult can be abused, but there are situations that make it more likely. For instance, people with disabilities are at higher risk, and so are people with memory problems or dementia. Also, abuse occurs more often to older adults who need help with basic activities, such as bathing, dressing, and taking medicine. Abuse is more likely to occur when: ● The caregiver is depressed ● The caregiver views their situation as a burden and without reward ● The caregiver abuses alcohol or drugs ● The caregiver and older adult are socially isolated ● The older adult was an abuser in the past ● There’s a history of domestic violence What can you do? If you’re being abused, the most important thing you can do is tell someone. That can be your doctor, a family member, or a trusted friend. Or you can call one of the hotlines at right. If you suspect someone else is being abused, try to talk to them alone. Let them know you’re worried about them. Continue to visit them to earn their trust and see how they’re doing. You can also report your concerns to one of these agencies: ● Eldercare Locator: 1-800-677-1116 ● National Adult Protective Services Association: (202) 370-6292 ● National Center on Elder Abuse: 1-855-500-3537 ● National Elder Fraud Hotline: 1-833-372-8311 Call 911 if you or someone else needs help right away. ● Open the test kit and follow the directions. Be sure to use the correct angle, placement, and movement of the swab when taking a sample Use the timer to make sure you read the results within the time frame given in the instructions. Reading them before or after may give you an incorrect result. Throw away the collection swab once you’re done. Never reuse swabs or other parts of the test. If you test positive: ● Let your doctor know ● Inform anyone you have spent time with in the two days before you had symptoms or took the test ● Take steps to avoid spreading it: The CDC recommends that you stay home or isolate yourself for 10 days and wear a mask when around others How to test yourself for COVID-19 If you have questions about your results, speak with your provider to understand what they mean. —Continued from front page

www.phs.org/Medicare 3 Are you a long-distance caregiver? You may be if you live an hour or more from someone — such as a family member — who needs your help. If you are participating in the care of someone far away, then you know that being a long-distance caregiver isn’t easy. Below are some tips that may make a difficult job more manageable: Be informed. Learn as much as you can about your loved one’s medical condition, medicines, and available resources. Keep all information in one place and up-to-date. Make copies for other caregivers and family members. This will help you stay on top of what’s going on with your loved one’s health and possibly prevent a crisis. Plan visits ahead of time. If you are able to go see your loved one, check with other caregivers to see what needs to be done. For example, does your mother need new clothes? Would it be helpful if you could meet with your father’s doctor? Try to spend time with your loved one doing things that are unrelated to being a caregiver, like watching a movie or playing a game. Make it easy to stay connected. Consider buying your loved one a simple cellphone if they don’t already have one. Program important numbers into it. Encourage them to stay in touch. Organize paperwork. You may need access to your loved one’s personal, health, financial, and legal records. Gather all this information together. Once you have a handle on this, other caregiving tasks — like talking to your loved one’s doctor or lawyer — may be easier to manage. Consider getting caregiving training. We’re not born knowing how to be a caregiver. Training can teach you how to safely transfer a person from a bed to a chair, how to prevent and treat bed sores, and basic first aid — skills you might need when you visit your loved one. Check with your local chapter of the American Red Cross to see if they offer this type of training or know who does. Hire a local care manager, if you can. They are often licensed nurses or social workers trained in care management. Their services can be expensive. But just a consult with a care manager may be all you need. How to make the best of long-distance caregiving You can find eldercare professionals in your area by visiting the Aging Life Care Association at www.aginglifecare.org.

4 WOMEN Understand your risk for osteoporosis About eight million women in the U.S. have osteoporosis, which means “porous bone.” According to the National Osteoporosis Foundation, one in two women will experience a broken bone due to osteoporosis in her lifetime. Osteoporosis occurs when the body loses too much bone material, makes too little new bone, or both. The bone’s structure becomes less dense, which means it can break more easily than healthy bones. This often happens unexpectedly because the disease has no outward symptoms. A fall or a simple bump can lead to a broken hip, wrist, or other bone. Why women are at high risk Older women are most vulnerable to developing osteoporosis. Their estrogen levels, which help protect bone density, decline after menopause. That’s why it’s recommended that women 65 and older get bone mineral density tests to see if they already have the disease or are at risk of getting it. Other key factors include a family history of osteoporosis or broken bones after age 50, as well as the following: ● Having early menopause or ovaries removed before menopause ● Not getting enough calcium or vitamin D throughout life ● Not exercising or being on extended bed rest ● Smoking ● Taking medications, including medicines for arthritis and asthma or some cancer drugs, that may decrease bone density ● Having a small body frame How to prevent osteoporosis or stop it from progressing You can do a lot to help protect your bones: ● Eat a diet rich in calcium and vitamin D, and stay physically active with weight-bearing activities such as weight training, walking, and climbing stairs. ● Stop smoking if you smoke. ● Know the risks of alcohol and how it can reduce bone mass. ● Maintain a healthy weight. Being underweight can increase the risk of fracture and bone loss. ● Work with your doctor to assess your risk and options. Your doctor can offer treatment options for rebuilding bone or slowing bone loss. Also, discuss strategies for avoiding bone-loss side effects from drugs you may take for other conditions. Osteoporosis is common, but it is preventable. By establishing healthy habits, you can reduce your risk of a broken bone. Sources: National Institutes of Health; National Osteoporosis Foundation Our local Presbyterian Customer Service Center (PCSC) is here to help! We’re available Monday through Friday, 8 a.m. to 6 p.m. Members can reach the PCSC at the following numbers: Presbyterian Senior Care (HMO)/(HMO-POS) and Presbyterian MediCare PPO members, call: (505) 923-6060 or 1-800-797-5343, TTY: 711 Presbyterian Dual Plus (HMO D-SNP) members, call: (505) 923-7675 or 1-855-465-7737, TTY: 711 OTHER IMPORTANT NUMBERS: PresRN: (505) 923-5677 or 1-888-730-2300, TTY: 711 New Mexico Crisis and Access Line (for a behavioral health crisis): 1-855-662-7474 (1-855-NMCRISIS) DentaQuest: 1-888-278-7310 or visit www.dentaquest.com TruHearing: 1-866-202-0110 Superior Vision: 1-800-879-6901 or visit www.superiorvision.com (for D-SNP members only) Routine transportation (for non-emergency medical transportation): 1-855-774-7737 (for most D-SNP members only; not available in some counties) Over-the-counter benefit — Nations OTC: 1-833-746-7682 or visit www.nationsotc.com (for most D-SNP members only; not available in some counties) Keep these numbers handy

www.phs.org/Medicare 5 Exercise does more than build strong muscles — it helps your bones. While your bones are growing, until you’re about 25 years old, exercise helps strengthen them. Later in life, exercise helps you preserve the bone mass you built in your youth. If you don’t take care of your bones, you risk developing osteoporosis. That’s a disease that leads to fragile bones, which are more prone to breaking. There are two types of exercise you can do to help fend off osteoporosis. Weight-bearing exercises This includes any activity you do on your feet that works your bones and muscles against gravity. When your feet and legs support your body weight, it makes your bones work harder. Examples of weight-bearing exercises include: ● Brisk walking and hiking ● Jogging and running ● Dancing ● Tennis ● Stair climbing ● Using an elliptical training machine If you have osteoporosis or are at risk for it, you may want to avoid high-impact exercises like jogging, running, or dancing. Low-impact activities like walking or using a stair-step machine may be better for you. Strength-training exercises Strength-training exercises add resistance to movement, which makes both muscles and bones work harder. Examples of strength-training exercises include things like: ● Lifting free weights ● Using elastic exercise bands ● Using weight machines ● Lifting your own body weight with moves like pushups Howmuch is enough? According to the American Academy of Orthopaedic Surgeons, a good goal for bone health is 30 minutes of weight-bearing exercise four or more days a week. For strength-training, try to work each major muscle group at least twice a week. But always rest for a full day between strengthtraining sessions. Additional source: National Osteoporosis Foundation The four types of exercise There are four main types of exercise that can help keep your body and mind healthy. By doing a combination of these exercises, you can improve your health and help prevent injuries. See the list below for each type of exercise. Aerobic Keeps heart, lungs, and circulatory system healthy — improving overall fitness. Strength Builds stronger muscles to support body movement. Balance Improves posture and stability and helps prevent falls. Flexibility Stretches muscles to help the body stay limber. How exercise helps keep bones strong

6 Depression can set in at any age Depression can happen to any of us as we age, and it can have many causes. It might be brought on by the loss of a loved one or other life changes. It may run in your family. Sometimes, it goes hand in hand with an illness like heart disease or cancer. The side effects of medicines can play a role in depression too. Whatever its cause, depression is never a normal part of aging. It’s a medical condition that can be treated. Could you be depressed? Depression isn’t something you can just snap out of. Most people need treatment to feel better. So it’s good to know the signs. You might be depressed if you have any of these symptoms for more than two weeks: ● A sad or empty mood ● Feeling hopeless, guilty, or worthless ● Loss of interest in things that once gave you pleasure ● Frequent crying Still, depression in older adults can look different than in younger ones. Late in life, people with depression may be more likely to: ● Feel tired ● Feel irritable ● Have trouble sleeping ● Have health problems, such as worsening headaches ● Have a hard time focusing ● Be confused Reach out If there’s any chance you’re depressed, tell your provider. Your provider will want to rule out certain diseases and medicines that can cause the same symptoms. If you are depressed, treatment can help you feel like yourself again. It may include talk therapy or medicine, or both. There may be lifestyle changes that can help too. Early treatment can help keep your depression from getting worse. That’s why it’s so crucial to speak up if you’re struggling. Presbyterian Medicare members also have access to talk therapy sessions to meet with a licensed therapist from MeMD’s network of providers for a $0 cost (Presbyterian Dual Plus members are excluded). To begin with talk therapy: • Go to www.phs.org • Under “Access Patient Care,” select “Get Care” • Select the “Behavioral Health” tile under “Get Care Later” • Scroll down the page and select “Talk Therapy Video Visits with MeMD” • Click the “Get Started” button • Complete the sign-up information and schedule your talk therapy visit MeMD therapists do not prescribe medication but instead provide talk therapy to pinpoint your needs, establish a treatment plan, and measure your progress. Sources: American Academy of Family Physicians; National Institute on Aging

www.phs.org/Medicare 7 Improving your experience Presbyterian members are at the center of what we do. Your experience — how you feel — as a valued Presbyterian Health Plan (PHP) member is important to us. We conduct surveys in an effort to hear what members just like you are saying. We value your feedback. When you receive a survey from us, it is really important that you participate. We use the feedback to improve things for you. Using some of your survey responses, we hope we can continue to improve your experience with us. Some things we are working on for you include: • Coordinating how we communicate with you • Making things more valuable for you • Improving new member onboarding processes • Improving your experience with our customer service staff • Improving our website • Improving telehealth options Some of these changes you will see over the course of the next year. We hope these changes will help your overall healthcare experience. We appreciate your feedback and look forward to hearing from you. myPRES: Be in the know myPRES is our secure member site that allows you to view important information about your health plan. Log in to myPRES, Presbyterian’s secure online member and patient portal, where you can: ● Pay your health plan premium ● Order prescriptions ● View or request a replacement member ID card ● Access Video Visits ● View preference center ● Look up benefit information securely, view claims status, and track deductibles Register for myPRES today: Go to www.phs.org/ mypres and click REGISTER NOW. Video Visits Video Visits and telehealth help you stay healthy while staying safe. Talk to your provider from the comfort of your own home. Make an appointment today through your myPRES account at www.phs.org. If you need help logging into your account, call the number on the back of your Presbyterian ID card. PresRN Speak with a Presbyterian nurse if you are not feeling well and do not know what to do. PresRN phone calls are free and available 24 hours a day, 365 days a year. Our nurses are happy to answer general health questions when you are healthy too. Call PresRN at: (505) 923-5573 or 1-800-887-9917. Presbyterian Senior Connection Presbyterian Senior Connection gives you a variety of health promotion, educational, Tools you can use! and social opportunities. These include education series, physical activity programs, senior services, sun tours, and local business discounts. Phone: (505) 823-8303 Hours: Monday through Friday, 8 a.m. to 4 p.m. SilverSneakers: Go digital to help you keep up your fitness routine Exercise is a key part of maintaining a healthy lifestyle and can support a healthy immune system. You can use your SilverSneakers® benefit to stay active without leaving home. SilverSneakers videos when and where you want! Check out hundreds of online workout videos with SilverSneakers OnDemand™. Videos range from easy, lowimpact exercises to cardio workouts. Log in at www.SilverSneakers.com to get started! Presbyterian events Presbyterian offers events and classes to further the health of patients and communities across the state. Review upcoming events or identify specific events by topic or region. Visit www.phs.org/events to learn more. If you would like to share your thoughts, please email feedback@phs.org. We want you to know that we are listening.

8 $0 telehealth benefit for 2022 Presbyterian Senior Care (HMO) and Presbyterian MediCare PPO members can make a telehealth appointment with most in-network providers for $0. Telehealth or telemedicine appointments are visits with a provider through video or online messaging services. Using telehealth allows members to safely and more easily access care when they may have a hard time making an in-person visit. It also gives members more options to get the care they need to stay healthy. This benefit only applies to in-network providers, including primary care, urgent care, specialty care, and therapy providers. For plans with a deductible, telehealth appointments are 0 percent cost share after the deductible is met. Not all providers offer telehealth services, and it is not advised for all services. We advise members to contact their provider to learn more about their telehealth options. Please note that members on a Presbyterian Dual Plus plan may pay 0 percent to 20 percent of the total cost for telehealth benefits. There are many options for members to get care online or by phone. Our telehealth options vary by a member’s healthcare needs, provider, and insurance plan. For a complete list of telehealth options, please visit our telehealth webpage at www.phs.org/tools-resources/ member/telehealth. Our Quality Improvement Program Presbyterian Health Plan, Inc., and Presbyterian Insurance Company, Inc., (Presbyterian) are committed to providing quality care and services to our members. We have a comprehensive Quality Improvement Program (QI Program) that evaluates the care and services you receive. Our goal is to work continually to improve your experience with care and services. The QI Program includes: • Member experience activities • Quality and safety of clinical care • Quality of service • Annual goals, processes, and activities At the end of each year, we review the QI Program to see how we did. Winston Churchill is credited with saying, “Never let a good crisis go to waste.” We learned and implemented many new ways to better serve you in 2020 that we have taken into 2021 and beyond. We use the results to find the areas that we need to improve. Here are just a few of our 2020 activities and results: • Developed and deployed a 14-day meal delivery program for members with COVID-19 who did not have good access to food • Developed a statewide home monitoring program for members who tested positive for COVID-19 but did not require hospitalization • Expanded Video Visits to support continued healthcare • Identified health disparities and worked to provide equitable access to healthcare and services

www.phs.org/Medicare 9 2022 annual eyewear/ vision benefit Good news for Presbyterian Senior Care plan HMO members who have the $250 annual routine vision allowance in 2022. You now have the option to go to a non-contracted vision eyewear provider, with a valid vision prescription, and pay for your routine eyewear out-of-pocket. We developed a direct member reimbursement process that will get you reimbursed up to $250 if you choose to go to a noncontracted provider for your routine eyewear. You must still receive an eye exam using an innetwork vision provider. You still have the option to use your benefit at any of our contracted vision providers. You will be required to pay any amounts that exceed the $250 benefit. Contact the Presbyterian Customer Service Center at (505) 923-7675 or 1-855-465-7737 (TTY: 711) to learn how you can be reimbursed up to the annual maximum. To your good health — simple things help make healthy aging possible Have you noticed that the numbers you read seem to be getting smaller? Do you find it harder to get down on your knees to look under the bed, and to get up again? There’s no question that age brings changes to our lives. And yes, some of them we’d prefer to avoid. Physically, for example, stiffening joints can make it harder to get around. Many people find that their short-term memory just isn’t what it used to be. Often, difficult personal situations, such as the death of a spouse, can add to the negative changes. Age can bring positive changes too. One survey found that many older people say they have less stress and more time for family, interests, and hobbies than they used to. In fact, the vast majority of older people report they are satisfied with their lives. To a great extent, what older age will be like for you depends on how you live now. It also depends on how you cope with the changes that come your way. You can’t turn back time. Still, you can take steps to help make getting older easier and more pleasant. Here are a few tips: ● Decide to have an active mind and body. Remember the saying “use it or lose it.” ● Be involved. Isolation can contribute to depression and other health problems. Stay connected to family and friends. Social connections can help ensure that you have physical and emotional support for what comes your way. ● Choose a healthy lifestyle. Try to eat well, maintain a healthy weight, and get plenty of rest. Also, do what you can to stay safe and see your doctor regularly. ● Make the most of your spare time. Do things you enjoy, and allow yourself some downtime. Too much stress can bring on a host of health problems. ● Practice healthy ways to cope. Believe in yourself, and remember that you can handle whatever comes your way. Sources: AARP; Mental Health America; National Institutes of Health

10 Your voice. Your value. Your healthcare Your decisions about what type of medical care you want are important. When we share our healthcare preferences through an advance directive, our loved ones and healthcare providers never have to guess what we would want if there were to be a time that we couldn’t make our decisions. Everyone deserves to have their healthcare wishes known and honored. To some people the concept of advance care planning might be new or unfamiliar. Advance care planning is simply thinking about what types of medical care are most in line with your faith, values, and personal definition of quality of life. Spending this time reflecting about what type of care you want or do not want, and how you want to be cared for, will allow you to develop a plan called an advance directive. This can offer valuable peace of mind to you and your loved ones. There are no right or wrong answers in advance care planning. What is best for you might be different for another person. The only thing that is the same for all adults is that advance care planning is an important part of routine healthcare. Please follow the steps below to make sure you are always at the center of your healthcare. First, decide who you want to make medical decisions for you in case you can’t make or voice your wishes. This should be the person or people who will be the best advocate for you. This can be a family member, but family can be too emotionally involved at times. Be sure to ask if they are willing to serve in this trusted role. Next, think about what type of healthcare is important to you. Any medical care can include benefits as well as burdens. Make sure you understand both the potential benefits and burdens of any care choices that you make. Your medical provider can help with questions that you might have. Now, complete an advance directive. Presbyterian has made the process easy with a new electronic advance directive. You can access this site in your Presbyterian MyChart by selecting “Advance Directives” from the menu options, or you can visit www.phs.org/tools-resources/patient/Pages/advance-directive.aspx for more information. Support is available to navigate these conversations. Presbyterian offers free sessions with advance care planning specialists. To schedule an appointment, call 1-866-773-7226.

www.phs.org/Medicare 11 Presbyterian Dual Plus (HMO D-SNP) Corner Are you a member who qualifies for both Medicare and Medicaid benefits? Then Presbyterian Dual Plus (HMO D-SNP) may be for you! Our service area includes all counties in New Mexico! Dual Plus offers an expanded network to include Lovelace, the University of New Mexico (UNM), and St. Vincent de Christus. To find out if your provider accepts our plan, please call the Presbyterian Customer Service Center at the number listed at right. Please note that supplemental benefits like dental and over-the-counter (OTC) benefits vary depending on county. For more information on our Presbyterian Dual Plus (HMO D-SNP) plan, call us! Our licensed Health Plan Insurance Consultants are here to help! Phone: (505) 923-8458 Toll-free: 1-800-347-4766 TTY: 711 Hours: 8 a.m. to 7 p.m., Monday through Saturday (except holidays) If you are already a Presbyterian Dual Plus (HMO D-SNP) member, here are some frequently asked questions that might help you! For additional information on your benefits, the Presbyterian Customer Service Center is here to help! Call us at (505) 923-7675 or 1-855-465-7737. You can also visit www.phs.org/dualplus for more information. Q: What is the benefit that we receive on our over-thecounter card? A: The OTC card is mailed ready to use with $305 loaded each quarter. Important: The OTC card benefit is not available in all counties. Q: What is the name of the company that I order my products from? A: You can place an order online using www.ConveyBenefits.com/Presbyterian. You can also place an order over the phone by calling OTC Advocates at 1-855-885-5737 (TTY: 711). Q: How can I tell which OTC products are covered in the store? A: The OTC Network Mobile App allows you to keep track of your balance and find eligible items when shopping at participating retailers. You can also call the Presbyterian Customer Service Center at the number below to obtain a list of covered products. Q: How do I schedule transportation? A: Please contact Secure Transportation at 505-923-6300 or toll-free at 1-855-774-7737. Q: Do I have dental coverage? A: The plan covers a $3,000 annual limit benefit. The benefit includes some preventive and comprehensive services. For more detailed information, please contact the Presbyterian Customer Service Center at the number listed below. Important: The dental coverage benefit is not available in all counties. Q: Can I get glasses on the plan? A: Yes, the plan offers a $275 annual benefit for routine eyewear (frames, lenses, contacts, and contact lens fitting).

Yourstory Your Story is published as a community service for the friends and patrons of: Presbyterian Health Plan and Presbyterian Insurance Company, Inc. Managing editor: fluentqc@phs.org A publication of Presbyterian Medicare Advantage Plans. Information in Your Story comes from a wide range of medical experts. Models may be used in photos and illustrations. If you have any concerns or questions about specific content that may affect your health, please contact your healthcare provider. 2022 © Coffey Communications, Inc. All rights reserved. Y0055_MPC032244_ NSR_C_03212022 Like us on Facebook Facebook.com/PresHealth Obtaining needed care during a state of disaster or public health emergency Presbyterian Medicare Advantage Plans, including Presbyterian Senior Care (HMO)/ (HMO/POS), Presbyterian MediCare PPO, and Presbyterian Dual Plus (HMO D-SNP), will ensure access to benefits in the following manner when a state of disaster or public health emergency is declared: ● Cover Medicare Part A and B services and supplemental Part C benefits furnished at non-contracted facilities ● Waive requirements for gatekeeper referrals where applicable ● Provide the same cost-sharing as if the service or benefit had been furnished at a contracted facility ● Make the changes that benefit members effective immediately without the required 30-day notice The Centers for Medicare & Medicaid Services states that a declaration of disaster may be made by one of the following: ● Presidential declaration of disaster or emergency under either the Stafford Act or the National Emergencies Act ● Secretarial declaration of a public health emergency under section 319 of the Public Health Service Act ● Declaration by the governor of the state of New Mexico If the president has declared a disaster, the secretary of Health and Human Services may also authorize waivers or modifications under section 1135 of the Public Health Service Act. The state of disaster or public health emergency ends when any of the following occur: ● The source that declared the state of disaster or public health emergency declares an end ● Centers for Medicare & Medicaid Services declares an end of the state of disaster or public health emergency ● Thirty (30) days have passed since the declaration of disaster or public health emergency was declared

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