A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that provides coverage for cancer treatment shall provide coverage for a prescribed, orally administered anticancer medication that is used to kill or slow the growth of cancerous cells on a basis no less favorable than intravenously administered or injected cancer medications that are covered as medical benefits by the plan.
B. A group health plan shall not increase patient cost-sharing for anticancer medications in order to achieve compliance with the provisions of this section.
C. Coverage of orally administered anticancer medication shall not be subject to any prior authorization, dollar limit, copayment, deductible or coinsurance provision that does not apply to intravenously administered or injected anticancer medication used to kill or slow the growth of cancerous cells.
History: Laws 2011, ch. 55, § 1.
Effective dates. — Laws 2011, ch. 55, § 7 made Laws 2011, ch. 55, § 1 effective June 17, 2011.
Applicability. — Laws 2011, ch. 55, § 6 provided that the provisions of this act apply to insurance policies that provide coverage for cancer treatment and that are delivered, issued for delivery, amended, renewed or continued in this state on or after January 1, 2012.
Structure New Mexico Statutes
Chapter 13 - Public Purchases and Property
Article 7 - Health Care Purchasing
Section 13-7-2 - Purpose of act.
Section 13-7-4 - Mandatory consolidated purchasing.
Section 13-7-5 - Consolidated purchasing for other persons.
Section 13-7-6 - Use of social security numbers.
Section 13-7-7 - Consolidated administrative functions; benefit.
Section 13-7-8 - Maximum age of dependent.
Section 13-7-9 - General anesthesia and hospitalization for dental surgery.
Section 13-7-10 - Hearing aid coverage for children required.
Section 13-7-11 - Required coverage of patient costs incurred in cancer clinical trials.
Section 13-7-12 - Coverage for orally administered anticancer medications; limits on patient costs.
Section 13-7-13 - Coverage of prescription eye drop refills.
Section 13-7-14 - Coverage for telemedicine services.
Section 13-7-15 - Prescription drugs; prohibited formulary changes; notice requirements.
Section 13-7-17 - Pharmacy benefits; prescription synchronization.
Section 13-7-19 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 13-7-20 - Prior Authorization Act.
Section 13-7-21 - Physical rehabilitation services; limits on cost sharing.
Section 13-7-22 - Coverage for contraception.
Section 13-7-23 - Pharmacist prescriptive authority services; reimbursement parity.
Section 13-7-24 - Heart artery calcium scan coverage.