Section 59A-22-52 – Prescription drug prior authorization protocols.
A. After January 1, 2014, a health insurer shall accept the uniform prior authorization form developed pursuant to Sections 2 [59A-2-9.8 NMSA 1978] and 3 [61-11-6.2 NMSA 1978] of this 2013 act as sufficient to request prior authorization for prescription drug benefits. B. No later than twenty-four months after the adoption of national standards for […]
Section 59A-22-53 – Pharmacy benefits; prescription synchronization.
A. An individual health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state and that provides a prescription drug benefit shall allow an insured to fill or refill a prescription for less than a thirty-day supply of the prescription drug, and apply a […]
Section 59A-22-42 – Coverage for prescription contraceptive drugs or devices.
A. Each individual and group health insurance policy, health care plan and certificate of health insurance delivered or issued for delivery in this state that provides a prescription drug benefit shall provide, at a minimum, the following coverage: (1) at least one product or form of contraception in each of the contraceptive method categories identified […]
Section 59A-22-43 – Required coverage of patient costs incurred in cancer clinical trials.
A. A health plan shall provide coverage for routine patient care costs incurred as a result of the patient’s participation in a cancer clinical trial if: (1) the clinical trial is undertaken for the purposes of the prevention of or the prevention of reoccurrence of cancer or the early detection or treatment of cancer for […]
Section 59A-22-44 – Coverage for smoking cessation treatment.
A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered or issued for delivery in this state and that offers maternity benefits shall offer coverage for smoking cessation treatment. B. Coverage for smoking cessation treatment may be subject to deductibles and coinsurance consistent with those imposed […]
Section 59A-22-45 – Coverage of alpha-fetoprotein IV screening test.
An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in the state shall provide coverage for an alpha-fetoprotein IV screening test for pregnant women, generally between sixteen and twenty weeks of pregnancy, to screen for certain genetic abnormalities in the fetus. […]
Section 59A-22-46 – Coverage of part-time employees.
An insurer that provides group health insurance pursuant to Chapter 59A, Article 22 NMSA 1978 shall make available, upon an employer’s request prior to issuance, delivery or renewal, coverage for regular part-time employees who work or are expected to work an average of at least twenty hours per week over a six-month period. Nothing in […]
Section 59A-22-47 – Coverage of colorectal cancer screening.
A. An individual or group health insurance policy, health care plan and certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for colorectal screening for determining the presence of precancerous or cancerous conditions and other health problems. The coverage shall make available colorectal cancer screening, as […]
Section 59A-22-48 – General anesthesia and hospitalization for dental surgery.
A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for hospitalization and general anesthesia provided in a hospital or ambulatory surgical center for dental surgery for the following: (1) insureds exhibiting physical, intellectual or […]
Section 59A-22-49 – Coverage for autism spectrum disorder diagnosis and treatment.
A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage to an insured for: (1) well-baby and well-child screening for diagnosing the presence of autism spectrum disorder; and (2) treatment of autism spectrum disorder through […]