Section 59A-22A-1 – Short title.

Chapter 59A, Article 22A NMSA 1978 shall be known and may be cited as the “Preferred Provider Arrangements Law”. History: 1978 Comp., § 59A-22A-1, enacted by Laws 1993, ch. 320, § 59.

Section 59A-22A-2 – Purpose.

The purpose of the Preferred Provider Arrangements Law is to encourage health care cost containment while preserving quality of care by allowing health care insurers to enter into preferred provider arrangements in accordance with minimum standards for preferred provider arrangements and for the health benefit plans associated with those arrangements. History: 1978 Comp., § 59A-22A-2, […]

Section 59A-22A-3 – Definitions.

As used in the Preferred Provider Arrangements Law: A. “covered person” means any person on whose behalf the health care insurer is obligated to pay for or to provide health benefit services; B. “covered services” means health care services which the health care insurer is obligated to pay for or to provide under a health […]

Section 59A-22A-4 – Preferred provider arrangements.

Notwithstanding any provisions of law to contrary, any health care insurer may enter into preferred provider arrangements. A. Such arrangements shall: (1) establish the amount and manner of payment to the preferred provider. Such amount and manner of payment may include capitation payments for preferred providers; (2) include mechanisms which are designed to minimize the […]

Section 59A-22A-5 – Health benefit plans.

A. Health care insurers may issue health benefit plans which provide for incentives for covered persons to use the health care services of preferred providers. Such policies or subscriber agreement shall contain at least the following provisions: (1) a provision that if a covered person receives emergency care for services specified in the preferred provider […]

Section 59A-22A-6 – Preferred provider participation requirements.

Health care insurers may place reasonable limits on the number or classes of preferred providers which satisfy the standards set forth by the health care insurer, provided that there is no discrimination against providers on the basis of religion, race, color, national origin, age, sex or marital status, and further provided that selection of preferred […]

Section 59A-22A-7 – General requirements.

Health care insurers complying with the Preferred Provider Arrangements Law shall be subject to and are required to comply with all other applicable laws, rules and regulations of this state. History: 1978 Comp., § 59A-22A-7, enacted by Laws 1993, ch. 320, § 65.