Your New Mexico Medical Bill Rights: Self-Attestation Stops All Collection, Medicare Rate Cap for Uninsured, and Complete Wage Garnishment Ban (2026 Guide)
New Mexico has one of the most powerful (and least-known) medical debt protections in the country. If your household income is at or below 200% of the Federal Poverty Level, a simple verbal statement can halt ALL collection activity. No lawsuits, no liens, no garnishment, no credit reporting, and no selling your debt. Hospitals must also cap charges for uninsured patients at Medicare rates. This page explains every protection available to you and how to assert them.
New Mexico Quick Reference: Key Protections
Self-Attestation Stops Collection
Verbal statement halts all actions for patients under 200% FPL
Medicare Rate Cap
Uninsured patients cannot be charged above Medicare rates
4-Year Statute of Limitations
Medical accounts expire after 4 years (not 6)
Garnishment Ban
Complete wage garnishment prohibition for indigent patients
Surprise Billing Protection
State law since January 2020 with 45-day refund rule
$150,000 Homestead Exemption
Your home equity is protected from medical debt judgments
Bilingual Notice Required
Bills must include rights notice in English and Spanish (14pt+)
Tribal Healthcare Protections
No copays at IHS, free premiums via NAPA up to 300% FPL
Important: You Must Actively Assert These Rights
New Mexico has strong laws on paper, but compliance by hospitals and collectors has been poor. Many facilities fail to inform patients of their indigency rights, do not provide bilingual notices, or continue collection despite valid attestations. You must know your rights, state them clearly (ideally in writing), and be prepared to file complaints if they are ignored. This guide shows you exactly how.
1. Self-Attestation of Indigency: The Most Powerful Protection in the Country
Under NMSA Section 57-32-4 and the implementing regulations at 13.10.39 NMAC, New Mexico created something extraordinary: a "magic words" protection that immediately halts all collection activity. If your income is at or below 200% of the Federal Poverty Level, you are classified as "indigent" under state law, and a single verbal statement is enough to trigger full protection.
What Self-Attestation Means in Practice
- No documentation required upfront. You do not need to produce pay stubs, tax returns, or any paperwork initially. Your verbal statement is enough.
- ALL collection must stop immediately. Once you attest, the hospital or collector cannot sue you, place liens on your property, garnish wages, sell your debt, or report it to credit bureaus.
- Works at any stage. Whether you received the bill yesterday or a collector has been calling for months, self-attestation triggers the same protections.
- Applies to hospital bills specifically. This law covers nonprofit hospitals, which includes most hospitals in New Mexico.
2026 Income Thresholds (200% FPL)
| Household Size | Annual Income (200% FPL) | Monthly Income |
|---|---|---|
| 1 person | $31,200 | $2,600 |
| 2 people | $42,400 | $3,533 |
| 3 people | $53,600 | $4,467 |
| 4 people | $64,400 | $5,367 |
| 5 people | $75,600 | $6,300 |
| 6 people | $86,800 | $7,233 |
Sample Self-Attestation Script
"I am writing to formally self-attest that my household income is at or below 200% of the Federal Poverty Level, making me "indigent" under NMSA Section 57-32-4 and 13.10.39 NMAC. Under this law, you are required to immediately cease ALL collection actions on my account, including but not limited to: lawsuits, liens, wage garnishment, sale of this debt, and credit reporting. No upfront documentation is required for this self-attestation to take effect. Please confirm in writing within 10 days that all collection activity has been halted. Failure to comply will result in complaints to the NM Attorney General and NM Office of Superintendent of Insurance."
Send this via certified mail (return receipt requested) for a paper trail. You can also make the verbal attestation by phone and follow up with this letter.
2025 Court Rule: Attestation of Indigency Form Now Required in Lawsuits
As of December 31, 2025 (Order S-1-RCR-2024-00076), any plaintiff filing a medical debt lawsuit in New Mexico must include the official Attestation of Indigency form with the complaint. This means every defendant in a medical debt case is now automatically notified of their self-attestation rights. If you receive a medical debt lawsuit, look for this form in your paperwork. Complete it and return it to the court to invoke protections.
If a collector files a lawsuit without including the indigency form, the filing may be deficient. Notify the court and consider filing a motion to dismiss for failure to comply with the court rules.
2. Medicare Rate Cap for Uninsured Patients
New Mexico hospitals must charge uninsured patients no more than Medicare rates. This is an extraordinary protection because hospital "chargemaster" prices (the list prices on your bill) are typically 3 to 5 times higher than what Medicare pays. This rate cap can reduce your bill by 50% to 80%.
How the Medicare Rate Cap Works
- Applies to all uninsured patients regardless of income level. You do not need to qualify as indigent.
- Example: A hospital stay billed at $45,000 on the chargemaster might be reduced to $12,000-$18,000 at Medicare rates.
- You must be truly uninsured. If you have insurance that simply denied the claim, this cap may not apply (though you should appeal the denial).
- Request a recalculation. If your bill shows chargemaster prices, write to the billing department citing this law and request they recalculate at Medicare rates.
Sample Letter: Request Medicare Rate Recalculation
"I am an uninsured patient and I am writing to request that my bill be recalculated at Medicare rates, as required by New Mexico law. The current charges on my account appear to reflect chargemaster pricing, which exceeds the legal maximum for uninsured patients. Please provide a revised bill showing Medicare-equivalent rates for all services rendered. If you believe this cap does not apply to my situation, please explain in writing with specific legal citations within 30 days."
Pro tip: You can look up Medicare rates for specific procedures at cms.gov to verify your recalculated bill. Search for the CPT codes on your itemized statement.
3. Complete Wage Garnishment Ban for Indigent Patients
Under NMSA Section 57-32-4, patients who qualify as indigent (at or below 200% FPL) are completely shielded from wage garnishment for medical debt. This is not a partial protection or a higher threshold. It is a total prohibition.
What the Garnishment Ban Covers
- No wage garnishment of any amount, from any employer
- No lawsuits can be filed or maintained against you for the debt
- No liens on your property (home, car, bank accounts)
- No credit reporting of the medical debt to any bureau
- No selling the debt to third-party collectors
For Patients Above 200% FPL
If your income exceeds 200% FPL, standard New Mexico garnishment rules apply. A creditor must first obtain a court judgment. Then garnishment is limited to the lesser of 25% of your disposable earnings or the amount by which your weekly disposable earnings exceed 40 times the state minimum wage. You can also challenge garnishment on hardship grounds.
4. Four-Year Statute of Limitations for Medical Debt
Under Section 37-1-4, the statute of limitations for medical debt in New Mexico is 4 years. This is significant because some collectors will argue that signed hospital paperwork converts the debt to a "written contract" with a 6-year limitation. New Mexico case law has established that medical bills are "accounts," not contracts, and the 4-year period applies.
Key Points About the 4-Year SOL
- The clock starts from the date of the last service or the date the bill became due (whichever is later).
- Making a partial payment can restart the clock. Be cautious about paying even small amounts on old medical debt.
- A written acknowledgment of the debt can also restart the clock. Never sign anything from a collector without reading it carefully.
- After 4 years, the debt is "time-barred." A collector cannot file a lawsuit. If they do, you can raise the SOL as an affirmative defense and the case should be dismissed.
- Collectors may still call about time-barred debt. They cannot threaten to sue you. If they do, this violates the Fair Debt Collection Practices Act (FDCPA).
Warning: If a collector argues your medical debt has a 6-year SOL because you signed admission paperwork, push back. Cite Section 37-1-4 and the classification of medical bills as "accounts" under NM case law. Consult an attorney if you receive a lawsuit on debt older than 4 years.
5. Surprise Billing Protection Act (HB 207, 2020)
New Mexico enacted the Surprise Billing Protection Act in January 2020, two years before the federal No Surprises Act took effect. The state law provides robust protections for patients who receive unexpected bills from out-of-network providers.
What Is Covered
- Emergency services: You cannot be balance-billed for emergency care at any facility, regardless of network status.
- Ancillary services at in-network facilities: If your hospital is in-network but the anesthesiologist, radiologist, or pathologist is out-of-network, you pay only in-network rates.
- 45-day refund requirement: If you pay a surprise bill before realizing it was improper, your insurer must refund you within 45 days of your request.
- Dispute resolution: The provider and insurer must resolve payment disputes between themselves. You are removed from the middle.
How to Use This Protection
If you receive a surprise bill from an out-of-network provider for emergency or ancillary services, do not pay it. Contact your insurer and cite the NM Surprise Billing Protection Act. If the insurer fails to act, file a complaint with the NM Office of Superintendent of Insurance at 1-855-427-5674.
6. HB 306: Facility Fee Ban (Effective January 1, 2027)
Signed into law in March 2026, House Bill 306 prohibits hospitals from charging facility fees for certain outpatient services. "Facility fees" are separate charges (often hundreds of dollars) that hospitals add on top of the professional fee simply because the visit takes place in a hospital-owned building. This law takes effect January 1, 2027.
Services Where Facility Fees Are Banned
- Preventive outpatient care: Annual physicals, well-child visits, preventive screenings
- Vaccinations: All routine and preventive immunizations
- Telehealth visits: Any telemedicine appointment conducted remotely
The law also requires hospitals to post visible signage informing patients about the facility fee ban. Starting in 2027, if you see a facility fee on your bill for preventive care, vaccinations, or telehealth, you can challenge it as a violation of HB 306.
7. Homestead Exemption: Protecting Your Home
Under Section 42-10-9, New Mexico protects $150,000 of home equity from creditors, including medical debt judgment holders. This means that even if a collector gets a court judgment against you (which should not happen if you are indigent and have self-attested), they cannot force the sale of your home unless your equity exceeds $150,000.
Key Homestead Exemption Details
- Standard exemption: $150,000 in home equity is protected
- Surviving spouse: $300,000 if your spouse died within the past 2 years
- Automatic adjustment: The exemption amount adjusts biennially (every two years)
- No filing required: The homestead exemption applies automatically to your primary residence in New Mexico
8. Hospital Liens: Limited to Personal Injury Recoveries
Under Sections 48-8-1 through 48-8-7, hospital liens in New Mexico work differently than in many states. A hospital can only place a lien against the proceeds of a personal injury recovery (such as a car accident settlement or lawsuit judgment). Hospitals cannot place liens on your home, car, or bank account simply because you owe a medical bill.
What This Means for You
- If you were injured due to someone else's negligence and received hospital care, the hospital can place a lien on any settlement or judgment you receive.
- If your medical bills are from routine care, illness, or elective procedures, the hospital cannot use a lien. It must pursue collection through standard channels (subject to all the protections above).
- If a hospital improperly threatens a lien on your property for non-PI medical debt, file a complaint with the NM Attorney General.
9. Bilingual Notice Requirement
New Mexico requires that medical bills include a notice of patient rights in both English and Spanish, printed in at least 14-point font. This notice must inform patients of their rights, including the right to dispute the bill and the right to request financial assistance.
Why This Matters
- New Mexico has a large Spanish-speaking population. The bilingual requirement ensures that language is not a barrier to exercising medical debt protections.
- If your bill does not include the required bilingual notice, the hospital may be in violation of state law. Document the missing notice and include it in any complaint.
- Compliance with this requirement has been inconsistent. Check your bills carefully and request the notice if it is missing.
10. Medicaid (Turquoise Care): Coverage for Nearly Half the State
Approximately 40% of New Mexico residents are enrolled in Medicaid (branded as "Turquoise Care"), one of the highest enrollment rates in the country. New Mexico expanded Medicaid under the ACA, covering adults up to 138% FPL. If you qualify, Medicaid can cover your medical bills with minimal or no cost-sharing.
Critical: 3-Month Retroactive Coverage
New Mexico Medicaid can cover bills up to 3 months before your application date, as long as you would have been eligible during that time. If you received medical care in the past 3 months and were uninsured but income-eligible, apply for Medicaid now. It may retroactively cover those bills.
- Income limit: 138% FPL for adults (about $21,500/year for a single person in 2026)
- Children: Covered up to 300% FPL through Medicaid/CHIP
- Pregnant individuals: Covered up to 250% FPL
- Apply online: yes.state.nm.us or call 1-800-997-2583
If you already have an unpaid hospital bill and are approved for Medicaid retroactively, notify the hospital billing department immediately. Provide your Medicaid ID and the date your coverage is effective. The hospital must re-bill Medicaid directly and cannot continue collecting from you for covered services.
11. Tribal Healthcare Rights: IHS, Tribal Health Centers, and NAPA
New Mexico is home to 23 federally recognized tribes (19 Pueblos, 3 Apache tribes, and the Navajo Nation). Native American and Alaska Native residents have unique healthcare rights that can eliminate medical costs entirely. These protections are underutilized, and many eligible individuals are unaware of the full scope of benefits available.
Indian Health Service (IHS) and Tribal Health Centers
- No copays, deductibles, or coinsurance at IHS facilities or Tribal Health Centers. Care is provided at no cost to eligible individuals.
- Eligibility: You must be a member of a federally recognized tribe or be able to document Native American descent. Some facilities serve all Native Americans regardless of tribal affiliation.
- Purchased/Referred Care (PRC): If IHS cannot provide a service directly, it may authorize and pay for care at outside facilities through the PRC program (formerly called Contract Health Services). You must get authorization before receiving outside care when possible.
- Emergency care: If you receive emergency care at a non-IHS facility, notify your IHS service unit within 72 hours to request PRC coverage of the bill.
Native American Premium Assistance (NAPA)
NAPA is a New Mexico program that pays health insurance premiums for eligible Native Americans. This allows tribal members to have both IHS access and private insurance coverage, which significantly expands the range of providers and services available.
- Income limit: Up to 300% FPL (about $46,800/year for a single person in 2026)
- What it covers: Monthly premiums for ACA marketplace plans or employer-sponsored insurance
- Apply through: beWellnm (the NM ACA exchange) or your tribal enrollment office
Special ACA Rules for Tribal Members
- Monthly special enrollment: Tribal members can change ACA marketplace plans every month, not just during open enrollment. This gives you the flexibility to switch to a plan with better coverage for a specific need at any time.
- Zero cost-sharing: Tribal members with income below 300% FPL enrolled in marketplace plans get $0 deductible, $0 copays, and $0 coinsurance for services from Indian health providers and for Essential Health Benefits.
- No penalty for late enrollment: Tribal members are exempt from coverage gaps that would otherwise result in a waiting period.
IHS Facilities in New Mexico
New Mexico has IHS service units in Albuquerque, Santa Fe, Gallup, Shiprock, Zuni, Mescalero, and other locations. Tribal Health Centers operated by individual tribes or pueblos are also located throughout the state. Contact your tribal enrollment office or call the Albuquerque Area IHS office at 505-256-6800 to find the nearest facility.
Important: If you received care at a non-IHS facility and are getting billed, check whether you qualify for PRC coverage retroactively. Also check Medicaid eligibility, as many Native Americans in New Mexico qualify for both IHS and Medicaid. Having Medicaid as well as IHS access ensures coverage when IHS facilities are unavailable or lack capacity.
12. How to Dispute a Medical Bill in New Mexico: Step by Step
Request an Itemized Bill
Ask for a line-by-line breakdown of all charges with CPT codes, dates of service, and quantities. You have the right to this document. Compare it against your medical records for services you did not receive or duplicate charges.
Check If You Qualify as Indigent
If your income is at or below 200% FPL, self-attest immediately (see Section 1 above). This is the fastest path to halting collection entirely.
Request the Medicare Rate Cap (If Uninsured)
If you are uninsured, demand that your bill be recalculated at Medicare rates. Send the sample letter from Section 2 above.
Apply for Financial Assistance
Even if you do not qualify as indigent, most New Mexico hospitals have financial assistance (charity care) programs for patients up to 300% or 400% FPL. Ask the billing department for the hospital's Financial Assistance Policy and application.
Check for Retroactive Medicaid Coverage
If your income is below 138% FPL and you were uninsured when you received care, apply for Medicaid. Coverage can be retroactive to 3 months before your application date.
Dispute Errors in Writing
Send a written dispute letter to the billing department identifying specific errors (wrong CPT codes, services not rendered, duplicate charges, coding upcoding). Request correction within 30 days. Keep a copy of everything.
Negotiate a Payment Plan or Settlement
If you owe a balance after all protections are applied, negotiate. Hospitals often accept 20-50% of the original bill as payment in full, especially for older debt. Request a zero-interest payment plan if you need monthly installments.
File Complaints If Rights Are Violated
If a hospital or collector violates any of the protections described on this page, file complaints with the NM Attorney General and the NM Office of Superintendent of Insurance. See the Resources section below for contact information.
13. Resources and Complaint Contacts
NM Office of Superintendent of Insurance
For insurance complaints, surprise billing, and coverage denials
Phone: 1-855-427-5674 (toll-free) or 505-827-4601
Online: osi.state.nm.us/en/complaints/
NM Attorney General
For unfair collection practices, violations of indigency protections
Phone: 1-844-255-9210
Online: nmag.gov/consumer-complaints
NM Center on Law and Poverty
Free legal assistance for low-income New Mexicans facing medical debt
Website: nmpovertylaw.org
Turquoise Care (Medicaid)
New Mexico Medicaid enrollment and questions
Phone: 1-800-997-2583
Apply: yes.state.nm.us
Albuquerque Area IHS
Indian Health Service regional office for New Mexico
Phone: 505-256-6800
Frequently Asked Questions
Q: What if the hospital demands documentation after I self-attest?
The law is clear: no documentation is required upfront. Your verbal self-attestation is legally sufficient to trigger all protections under NMSA 57-32-4. The hospital may ask for verification later, but all collection must stop in the meantime. If a hospital refuses to honor your attestation without documentation, file a complaint with the Attorney General immediately.
Q: Can a collector still call me after I self-attest?
The law prohibits all "collection actions," which includes dunning calls. If a collector continues to call after you have self-attested, document each call (date, time, caller name) and file complaints with both the NM Attorney General and the Consumer Financial Protection Bureau (CFPB). You may also have a claim under the FDCPA.
Q: Does the Medicare rate cap apply to ambulance bills?
The Medicare rate cap for uninsured patients applies specifically to hospital charges. Ambulance services may be operated by separate entities (fire departments, private companies) and may not be subject to the same cap. However, you should still request an itemized bill and negotiate. Many ambulance providers will reduce bills for uninsured patients upon request.
Q: My income fluctuates seasonally. Do I still qualify as indigent?
The determination is based on your current income at the time of attestation. If your income is below 200% FPL when you make the attestation, you qualify. Seasonal workers, gig workers, and self-employed individuals should attest during low-income periods. The hospital can request verification later, but must cease collection immediately upon your attestation.
Q: I am a tribal member but live in an urban area far from IHS facilities. What are my options?
Urban Indian Health Centers (such as First Nations Community HealthSource in Albuquerque) serve Native Americans in urban areas. You can also use the NAPA program to get free premiums for a marketplace plan, giving you access to any in-network provider. Additionally, the monthly special enrollment period means you can switch plans at any time to find better provider access.
Q: What if my medical debt is older than 4 years and a collector is still calling?
If the debt is older than 4 years, it is time-barred under Section 37-1-4. The collector cannot sue you. If they threaten legal action on time-barred debt, this violates the FDCPA. Do not make any payment or written acknowledgment, as this could restart the clock. You can send a written cease-and-desist letter under the FDCPA requiring them to stop contacting you.
Q: Does putting a medical bill on a credit card change my rights?
Yes. Once you pay a medical bill with a credit card, it becomes credit card debt, not medical debt. You lose all medical-debt-specific protections (indigency attestation, Medicare rate cap, the 4-year SOL). The credit card company's terms and interest rates apply instead. Never put a medical bill on a credit card before exploring all other options first.
Need Help With a New Mexico Medical Bill?
CareRoute helps New Mexico patients understand their rights, generate dispute letters, and navigate the self-attestation process. Our tools use the specific protections described on this page to help you reduce or eliminate medical debt.
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Legal Disclaimer
This page provides general information about New Mexico medical billing rights and protections. It is not legal advice and does not create an attorney-client relationship. Laws and regulations change frequently. The information on this page was last reviewed in May 2026. For advice about your specific situation, consult a qualified attorney. CareRoute is not a law firm and does not provide legal representation. If you are facing a lawsuit, seek legal counsel immediately. The NM Center on Law and Poverty (nmpovertylaw.org) provides free legal assistance to low-income New Mexicans.