A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that offers coverage of physical rehabilitation services shall not impose a member cost share for physical rehabilitation services that is greater than that for primary care services on a coinsurance percentage basis when coinsurance is applied or on an absolute dollar amount when a copay is applied.
B. As used in this section:
(1) "physical rehabilitation services" means services aimed at maximizing an individual's level of function, returning to a prior level of function or maintaining or slowing the decline of function, which services are provided by or under the direction of a licensed physical therapist, occupational therapist or speech therapist; and
(2) "primary care services" means the first level of basic or general health care for a person's health needs, including diagnostic and treatment services, initiation of referrals for other health care services and maintenance of the continuity of care when appropriate.
History: Laws 2019, ch. 188, § 1.
Effective dates. — Laws 2019, ch. 188, § 6 made Laws 2019, ch. 188, § 1 effective January 1, 2020.
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.