New Mexico Statutes
Article 7 - Health Care Purchasing
Section 13-7-7 - Consolidated administrative functions; benefit.

A. The publicly funded health care agencies, political subdivisions and other persons participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act may enter into a joint powers agreement pursuant to the Joint Powers Agreements Act [11-1-1 to 11-1-7 NMSA 1978] with the publicly funded health care agencies and political subdivisions to determine assessments or provisions of resources to consolidate, standardize and administer the consolidated purchasing single process and subsequent activities pursuant to the Health Care Purchasing Act. The publicly funded health care agencies, political subdivisions and other persons participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act may enter into contracts with nonpublic persons to provide the service of determining assessments or provision of resources for consolidation, standardization and administrative activities.
B. Each agency shall retain its responsibility to determine policy direction of the benefit plans, plan development, training and coordination with respect to participants and its benefits staff, as well as to respond to benefits eligibility inquiries and establish and enforce eligibility rules.
C. Notwithstanding Subsection B of this section, publicly funded health care agencies, political subdivisions and other persons participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act shall provide coverage for children, from birth through three years of age, for or under the family, infant, toddler program administered by the early childhood education and care department, provided eligibility criteria are met, for a maximum benefit of three thousand five hundred dollars ($3,500) annually for medically necessary early intervention services provided as part of an individualized family service plan and delivered by certified and licensed personnel who are working in early intervention programs approved by the early childhood education and care department. No payment under this subsection shall be applied against any maximum lifetime or annual limits specified in the policy, health benefits plan or contract.
History: Laws 2001, ch. 351, § 3; 2005, ch. 157, § 1; 2019, ch. 48, § 14.
The 2019 amendment, effective July 1, 2020, required publicly funded health agencies participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act to provide health coverage for eligible children under the family, infant, toddler program administered by the early childhood education and care department; deleted former Subsections A and B, which related to expired deadlines for certain publicly funded health care agencies, and redesignated former Subsections C through E as Subsections A through C, respectively; in Subsection B, after "Each agency", deleted "will" and added "shall"; and in Subsection C, after "family, infant, toddler program administered by the", added "early childhood education and care", after "department", deleted "of health", after "personnel", deleted "as defined in 7.30.8 NMAC", after "early intervention programs approved by the", added "early childhood education and care", and after "department", deleted "of health".
The 2005 amendment, effective July 1, 2005, added Subsection E to require coverage for children from birth through three years of age under the family, infant, toddler program for a maximum benefit of $3,500 for medically necessary early intervention services.
Only procedural law may be adopted by reference. Ballew v. Denson, 1958-NMSC-002, 63 N.M. 370, 320 P.2d 382; Middle Rio Grande Water Users Ass'n v. Middle Rio Grande Conservancy Dist., 1953-NMSC-035, 57 N.M. 287, 258 P.2d 391; Yeo v. Tweedy, 1929-NMSC-033, 34 N.M. 611, 286 P. 970; State v. Armstrong, 1924-NMSC-089, 31 N.M. 220, 243 P. 333.

Structure New Mexico Statutes

New Mexico Statutes

Chapter 13 - Public Purchases and Property

Article 7 - Health Care Purchasing

Section 13-7-1 - Short title.

Section 13-7-2 - Purpose of act.

Section 13-7-3 - Definitions.

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 13-7-16 - Coverage for autism spectrum disorder diagnosis and treatment; permissible limitations.

Section 13-7-17 - Pharmacy benefits; prescription synchronization.

Section 13-7-18 - Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions.

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.

Section 13-7-25 - Insulin for diabetes; cost-sharing cap.

Section 13-7-26 - Behavioral health services; elimination of cost sharing. (Effective January 1, 2022.)