Section 59A-46-50.5 – Heart artery calcium scan coverage.
A. A group health maintenance organization contract, other than a small group health maintenance organization contract, that is delivered, issued for delivery or renewed in this state shall provide coverage for eligible enrollees to receive a heart artery calcium scan. B. Coverage provided pursuant to this section shall: (1) be limited to the provision of […]
Section 59A-46-51 – Repealed.
History: Laws 2010, ch. 94, § 3; 2013, ch. 74, § 32; 2018, ch. 57, § 24; 2019, ch. 235, § 11; 2019, ch. 235, § 12; repealed by Laws 2021, ch. 108, § 37. ANNOTATIONS Repeals. — Laws 2021, ch. 108, § 37 repealed 59A-46-51 NMSA 1978, as enacted by Laws 2010, ch. 94, […]
Section 59A-46-52 – Prescription drug prior authorization protocols.
A. After January 1, 2014, a health maintenance organization 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 […]
Section 59A-46-52.1 – Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions.
A. Each individual or group health maintenance organization contract delivered or issued for delivery in this state that provides a prescription drug benefit for which any step therapy protocols are required shall establish clinical review criteria for those step therapy protocols. The clinical review criteria shall be based on clinical practice guidelines that: (1) recommend […]
Section 59A-46-52.2 – Pharmacist prescriptive authority services; reimbursement parity.
A carrier shall reimburse a participating provider that is a certified pharmacist clinician or pharmacist certified to provide a prescriptive authority service who provides a service pursuant to an individual or group contract at the standard contracted rate that the carrier reimburses, for the same service under that individual or group contract, any licensed physician […]
Section 59A-46-44 – Coverage for contraception.
A. Each individual and group health maintenance organization contract 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 by the federal food and drug administration; […]
Section 59A-46-45 – Coverage for smoking cessation treatment.
A. An individual or group health maintenance organization contract 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 on other benefits under the same contract. […]
Section 59A-46-38.1 – Coverage of children.
A. An insurer shall not deny enrollment of a child under the health plan of the child’s parent on the grounds that the child: (1) was born out of wedlock; (2) is not claimed as a dependent on the parent’s federal tax return; or (3) does not reside with the parent or in the insurer’s […]
Section 59A-46-46 – Coverage of alpha-fetoprotein IV screening test.
An individual or group health maintenance organization 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 […]
Section 59A-46-38.2 – Childhood immunization coverage required.
A. Each individual and group health maintenance contract delivered or issued for delivery in this state shall provide coverage for childhood immunizations, in accordance with the current schedule of immunizations recommended by the American academy of pediatrics, including coverage for all medically necessary booster doses of all immunizing agents used in childhood immunizations. B. Coverage […]