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Section 59A-46-1 - Short title. - Chapter 59A, Article 46 NMSA 1978 may be cited as...
Section 59A-46-2 - Definitions. - As used in the Health Maintenance Organization Law: A. "basic...
Section 59A-46-3 - Establishment of health maintenance organizations. - A. Notwithstanding any law of this state to the contrary,...
Section 59A-46-4 - Issuance of certificate of authority. - A. Upon receipt of an application for issuance of a...
Section 59A-46-5 - Powers of health maintenance organizations. - A. The powers of a health maintenance organization include, but...
Section 59A-46-6 - Fiduciary responsibilities; fidelity bond. - A. Any director, officer, employee or partner of a health...
Section 59A-46-7 - Quality assurance program. - A. A health maintenance organization shall establish procedures to assure...
Section 59A-46-8 - Requirements for group contract, individual contract and evidence of coverage. - A. Every group and individual contract holder is entitled to...
Section 59A-46-9 - Annual report. - A. Every health maintenance organization shall annually, on or before...
Section 59A-46-10 - Information to enrollees or subscribers. - A. A health maintenance organization shall provide to its subscribers...
Section 59A-46-11 - Grievance procedures. - A. Every health maintenance organization shall establish and maintain a...
Section 59A-46-12 - Investments. - With the exception of investments made in accordance with Paragraph...
Section 59A-46-13 - Protection against insolvency. - A. Health maintenance organizations shall be subject to the following...
Section 59A-46-14 - Uncovered expenditures insolvency deposit. - A. If at any time uncovered expenditures exceed ten percent...
Section 59A-46-15 - Enrollment period; replacement coverage in the event of insolvency. - A. In the event of an insolvency of a health...
Section 59A-46-16 - Filing requirements for rating information. - A. No premium rate may be used until either a...
Section 59A-46-17 - Regulation of health maintenance organization insurance producers. - A. Requirements and procedures for licensing of health maintenance organization...
Section 59A-46-18 - Powers of insurers. - A. An authorized insurer may either directly or through a...
Section 59A-46-19 - Examinations. - A. The superintendent may make an examination of the affairs...
Section 59A-46-20 - Suspension or revocation of certificate of authority. - A. Any certificate of authority issued under the provisions of...
Section 59A-46-21 - Rehabilitation, liquidation or conservation of health maintenance organizations. - A. Any rehabilitation, liquidation or conservation of a health maintenance...
Section 59A-46-22 - Summary orders and supervision. - A. Whenever the superintendent determines that the financial condition of...
Section 59A-46-22.1 - Repealed. - Repeals. — Laws 1991, ch. 9, § 45 repealed 59A-46-22.1...
Section 59A-46-23 - Regulations. - The superintendent may, after notice and hearing, adopt and promulgate...
Section 59A-46-24 - Fees. - Every health maintenance organization subject to the provisions of the...
Section 59A-46-25 - Penalties and enforcement. - A. The superintendent may, in lieu of suspension or revocation...
Section 59A-46-26 - Filings and reports as public documents. - All applications, filings and reports required under the Health Maintenance...
Section 59A-46-26.1 - Employer utilization and loss experience availability. - Employer claims information, including utilization and loss experience under health...
Section 59A-46-27 - Confidentiality of medical information and limitation of liability. - A. Any data or information pertaining to the diagnosis, treatment...
Section 59A-46-28 - Authority to contract. - The secretary of health, in carrying out his obligations as...
Section 59A-46-29 - Health maintenance organizations; contract or certificate provisions relating to individuals who are eligible for medical benefits under the medicaid program. - A. Each individual or group contract or certificate that is...
Section 59A-46-30 - Statutory construction and relationship to other laws. - A. The provisions of the Insurance Code [Chapter 59A NMSA...
Section 59A-46-31 - Coordination of benefits. - A. Health maintenance organizations are permitted, but not required, to...
Section 59A-46-32 - Continuation of coverage and conversion rights; health care plans. - A. Every individual or group contract entered into by a...
Section 59A-46-32.1 - Recompiled. - Recompilations. — Laws 1993, ch. 266, § 31, recompiled 59A-46-32.1...
Section 59A-46-33 - Governing body. - The governing body of any health maintenance organization may include...
Section 59A-46-34 - Prohibited practices. - A. No health maintenance organization, or representative thereof, may cause...
Section 59A-46-35 - Provider discrimination prohibited. - No class of licensed individual providers willing to meet the...
Section 59A-46-36 - Doctor of oriental medicine; discrimination prohibited. - Doctors of oriental medicine as a class of licensed providers...
Section 59A-46-37 - Coverage for adopted children. - A. No individual or group health maintenance organization contract shall...
Section 59A-46-38 - Newly born children coverage. - A. All individual and group health maintenance organization contracts delivered...
Section 59A-46-38.1 - Coverage of children. - A. An insurer shall not deny enrollment of a child...
Section 59A-46-38.2 - Childhood immunization coverage required. - A. Each individual and group health maintenance contract delivered or...
Section 59A-46-38.3 - Maximum age of dependent. - Each individual or group health maintenance organization contract delivered or...
Section 59A-46-38.4 - Coverage of circumcision for newborn males. - An individual or group health maintenance organization policy, health care...
Section 59A-46-38.5 - Hearing aid coverage for children required. - A. An individual or group health maintenance organization contract delivered,...
Section 59A-46-39 - Maternity transport required. - All individual and group health maintenance organization contracts delivered or...
Section 59A-46-40 - Home health care service option required. - A. Each health maintenance organization which delivers or issues for...
Section 59A-46-41 - Coverage for mammograms. - A. Each individual and group health maintenance organization contract delivered...
Section 59A-46-41.1 - Mastectomies and lymph node dissection; minimum hospital stay coverage required. - A. Each individual and group health maintenance contract delivered or...
Section 59A-46-41.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited. - A. An individual or group health maintenance organization contract that...
Section 59A-46-42 - Coverage for cytologic and human papillomavirus screening. - A. Each individual and group health maintenance organization contract delivered...
Section 59A-46-42.1 - Coverage for the human papillomavirus vaccine. - A. An individual or group health maintenance organization contract delivered,...
Section 59A-46-43 - Coverage for individuals with diabetes. - A. Each individual and group health maintenance organization contract delivered...
Section 59A-46-43.2 - Coverage for medical diets for genetic inborn errors of metabolism. - As of July 1, 2003, each health maintenance organization that...
Section 59A-46-44 - Coverage for contraception. - A. Each individual and group health maintenance organization contract delivered...
Section 59A-46-45 - Coverage for smoking cessation treatment. - A. An individual or group health maintenance organization contract that...
Section 59A-46-46 - Coverage of alpha-fetoprotein IV screening test. - An individual or group health maintenance organization policy, health care...
Section 59A-46-47 - Coverage of part-time employees. - A health maintenance organization that provides coverage for health care...
Section 59A-46-48 - Coverage of colorectal cancer screening. - A. An individual or group health maintenance organization contract that...
Section 59A-46-49 - General anesthesia and hospitalization for dental surgery. - A. An individual or group health maintenance organization contract delivered,...
Section 59A-46-50 - Coverage for autism spectrum disorder diagnosis and treatment. - A. An individual or group health maintenance contract that is...
Section 59A-46-50.1 - Coverage for orally administered anticancer medications; limits on patient costs. - A. An individual or group health maintenance organization contract that...
Section 59A-46-50.2 - Coverage of prescription eye drop refills. - A. An individual or group health maintenance organization contract that...
Section 59A-46-50.3 - Coverage for telemedicine services. - A. An individual or group health maintenance organization contract that...
Section 59A-46-50.4 - Prescription drugs; prohibited formulary changes; notice requirements. - A. As of January 1, 2014, an individual or group...
Section 59A-46-51 - Repealed. - History: Laws 2010, ch. 94, § 3; 2013, ch. 74,...
Section 59A-46-52 - Prescription drug prior authorization protocols. - A. After January 1, 2014, a health maintenance organization shall...
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...
Section 59A-46-52.2 - Pharmacist prescriptive authority services; reimbursement parity. - A carrier shall reimburse a participating provider that is a...
Section 59A-46-53 - Pharmacy benefits; prescription synchronization. - A. An individual or group health maintenance organization contract that...
Section 59A-46-54 - Provider credentialing; requirements; deadline. - A. The superintendent shall adopt and promulgate rules to provide...
Section 59A-46-55 - Coverage exclusion. (Contingent repeal. See note below.) - Coverage of vasectomy and male condoms pursuant to Section 7...
Section 59A-46-56 - Physical rehabilitation services; limits on cost sharing. - A. An individual or group health maintenance contract that is...
Section 59A-46-57 - Behavioral health services; elimination of cost sharing. (Effective January 1, 2022.) - A. Until January 1, 2027, an individual or group health...