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Section 59A-47-1 - Short title. - Chapter 59A, Article 47 NMSA 1978 may be cited as...
Section 59A-47-2 - Purpose; exemptions. - A. The purpose of this article is to provide for...
Section 59A-47-3 - Definitions. - A. "acquisition expenses" includes all expenses incurred in connection with...
Section 59A-47-4 - Organization; profit corporations prohibited; merger and consolidation of health care plans. - A. A corporation may be organized under the laws of...
Section 59A-47-5 - Qualifications for health care plan authority. - The superintendent shall not authorize any proposed health care plan...
Section 59A-47-6 - Preliminary permit for solicitations. - A. A newly-formed health care plan shall not solicit any...
Section 59A-47-7 - Escrow of preliminary premiums. - With its application for a preliminary permit as provided for...
Section 59A-47-8 - Certificate of authority required; application and conditions; exceptions. - A. No health care plan shall make health care expense...
Section 59A-47-9 - Issuance and denial of initial certificate of authority. - A. If after such investigation as he deems advisable the...
Section 59A-47-10 - Trust deposit. - A. Every health care plan shall make and thereafter maintain...
Section 59A-47-11 - Expiration, continuance of certificate of authority. - The certificate of authority of a health care plan issued...
Section 59A-47-12 - Suspension, revocation or refusal to continue certificate of authority. - The superintendent may suspend, revoke or refuse to continue the...
Section 59A-47-13 - Service of process; superintendent as attorney. - Prior to issuance of its initial certificate of authority, the...
Section 59A-47-14 - Annual statement. - As prerequisite to continuance of its certificate of authority, each...
Section 59A-47-15 - Assets. - In determining the financial condition of a health care plan...
Section 59A-47-16 - Reserves. - A health care plan shall establish and maintain reserves in...
Section 59A-47-17 - Examination. - A health care plan, or organizaion [organization] proposing or purporting...
Section 59A-47-18 - Investments. - A health care plan shall invest its funds only in...
Section 59A-47-19 - Limitation upon acquisition and administration expenses. - No health care plan shall during any one calendar year...
Section 59A-47-20 - Conflicts of interest as to certain transactions. - A. No director or officer of any health care plan,...
Section 59A-47-21 - Joint coverage, reinsurance. - Two (2) or more health care plans may enter into...
Section 59A-47-22 - Transfer of subscribership. - A. A health care plan may enter into agreements with...
Section 59A-47-23 - Subscriber contracts; coverage period. - Every health care expense payments contract made by a health...
Section 59A-47-24 - Subscriber contracts; requirements and provisions. - Every health care expense payments contract issued under this article...
Section 59A-47-25 - Subscriber contracts; filing, approval. - No health care plan shall make or issue any health...
Section 59A-47-26 - Premium rates; filing and approval. - A. No health care plan shall enter into any contract...
Section 59A-47-27 - Coverage for newly born children, maternity transport, home health care. - Subscriber contracts of a health care plan shall also be...
Section 59A-47-27.1 - Coverage of circumcision for newborn males. - An individual or group health insurance policy, health care plan...
Section 59A-47-28 - Coverage for service of chiropractor. - All individual and group subscriber contracts delivered or issued for...
Section 59A-47-28.1 - Coverage for service of certified nurse-midwives and registered lay midwives. - A. Any individual and group subscriber contracts delivered in New...
Section 59A-47-28.2 - Doctor of oriental medicine discrimination prohibited. - All individual and group subscriber contracts delivered or issued for...
Section 59A-47-28.3 - Provider discrimination prohibited. - All individual and group subscriber contracts delivered or issued for...
Section 59A-47-28.4 - Coverage for collaborative practice; dental therapists; dental hygienists. - An individual or group subscriber contract delivered or issued for...
Section 59A-47-29 - Settlement of disputes; appeal. - The parties to a dispute between a health care plan...
Section 59A-47-30 - Licensed insurance producers required; qualifications, licensing procedures and conditions. - A. Solicitation of subscriberships for a health care plan shall...
Section 59A-47-31 - Rehabilitation, liquidation or dissolution. - If the superintendent finds that expenses incurred by a health...
Section 59A-47-32 - Unauthorized contract or adjustment transactions; penalty. - A. Any person writing or attempting to write, solicit or...
Section 59A-47-33 - Other provisions applicable. - The provisions of the Insurance Code [Chapter 59A NMSA 1978]...
Section 59A-47-34 - Continuation of coverage and conversion rights; health care plans. - A. Every individual or group contract entered into by a...
Section 59A-47-35 - Alcohol dependency coverage. - A. Each health care plan that delivers or issues for...
Section 59A-47-36 - Nonprofit health care plans; contract or certificate provisions relating to individuals who are eligible for medical benefits under the medicaid program. - A. Each individual or group contract for health care expense...
Section 59A-47-37 - Coverage of children. (Effective July 1, 2020.) - A. An insurer shall not deny enrollment of a child...
Section 59A-47-37.1 - Hearing aid coverage for children required. - A. An individual or group health insurance policy, health care...
Section 59A-47-38 - Coverage for medical diets for genetic inborn errors of metabolism. - As of July 1, 2003, subscriber contracts of a health...
Section 59A-47-39 - Employer utilization and loss experience availability. - Employer claims information, including utilization and loss experience under health...
Section 59A-47-40 - Maximum age of dependent. - An individual or group health care coverage, including any form...
Section 59A-47-41 - Coverage of alpha-fetoprotein IV screening test. - An individual or group health insurance policy, health care plan...
Section 59A-47-41.1 - Prior authorization for gynecological or obstetrical ultrasounds prohibited. - A. An individual or group health insurance policy, health care...
Section 59A-47-42 - Coverage of part-time employees. - A health care plan that provides coverage for health care...
Section 59A-47-43 - Coverage of colorectal cancer screening. - A. An individual or group health policy, health care plan...
Section 59A-47-44 - General anesthesia and hospitalization for dental surgery. - A. An individual or group health insurance policy, health care...
Section 59A-47-45 - Coverage for autism spectrum disorder diagnosis and treatment. - A. An individual or group health insurance policy, health care...
Section 59A-47-45.1 - Coverage for orally administered anticancer medications; limits on patient costs. - A. An individual or group health insurance policy, health care...
Section 59A-47-45.2 - Coverage of prescription eye drop refills. - A. An individual or group health insurance policy, health care...
Section 59A-47-45.3 - Coverage for telemedicine services. - A. An individual or group health insurance policy, health care...
Section 59A-47-45.4 - Prescription drugs; prohibited formulary changes; notice requirements. - A. As of January 1, 2014, an individual or group...
Section 59A-47-45.5 - Coverage for contraception. - A. A health care plan delivered or issued for delivery...
Section 59A-47-45.6 - Coverage exclusion. (Contingent repeal. See note.) - Coverage of vasectomy and male condoms pursuant to Section 9...
Section 59A-47-45.7 - Heart artery calcium scan coverage. - A. A group health care plan, other than a small...
Section 59A-47-46 - Repealed. - History: Laws 2010, ch. 94, ยง 4; 2013, ch. 74,...
Section 59A-47-47 - Prescription drug prior authorization protocols. - A. After January 1, 2014, a health care plan shall...
Section 59A-47-47.1 - Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions. - A. Each individual or group nonprofit health care plan contract...
Section 59A-47-47.2 - Pharmacist prescriptive authority services; reimbursement parity. - A health care plan shall reimburse a participating provider that...
Section 59A-47-48 - Pharmacy benefit; prescription synchronization. - A. An individual or group health care plan that is...
Section 59A-47-49 - Provider credentialing; requirements; deadline. - A. The superintendent shall adopt and promulgate rules to provide...
Section 59A-47-50 - Physical rehabilitation services; limits on cost sharing. - A. An individual or group health care plan that is...
Section 59A-47-51 - Behavioral health services; elimination of cost sharing. (Effective January 1, 2022.) - A. Until January 1, 2027, an individual or group health...