No insurer or other provider of health care benefits regulated under Articles 22, 23, 24A, 44, 46, 47 or 54 of the Insurance Code shall, after July 1, 1989, issue, deliver or execute in this state any policy, plan, contract or certificate of health, medical, hospitalization, accident or sickness coverage unless the policy, plan, contract, certificate or other evidence of coverage provides for surgical and nonsurgical treatment of temporomandibular joint disorders and craniomandibular disorders, subject to the same conditions, limitations, prior review and referral procedures as are applicable to treatment of any other joint in the body and treatable by any practitioner of the healing arts as defined in Section 59A-22-32 NMSA 1978. The health care coverage for craniomandibular and temporomandibular joint disorders required by this section may be subject to reasonable copayments or coinsurance provisions and need not include coverage for orthodontic appliances and treatment, crowns, bridges and dentures unless the disorder is trauma related.
History: 1978 Comp., § 59A-16-13.1, enacted by Laws 1989, ch. 304, § 1; 1999, ch. 289, § 22.
Cross references. — For the Insurance Code, see 59A-1-1 NMSA 1978 and notes thereto.
The 1999 amendment, effective June 18, 1999, substituted "24A" for "24" in the list of Articles in the first sentence.
Structure New Mexico Statutes
Article 16 - Trade Practices and Frauds
Section 59A-16-1 - Scope of article.
Section 59A-16-2 - Purpose of article.
Section 59A-16-3 - Practices and acts prohibited, in general.
Section 59A-16-4 - Misrepresentation, false advertising of policies.
Section 59A-16-5 - False information, advertising.
Section 59A-16-6 - "Twisting" prohibited.
Section 59A-16-7 - Replacement of life insurance.
Section 59A-16-7.1 - Unclaimed life insurance benefits.
Section 59A-16-8 - Falsification, omission of records; misleading financial statements.
Section 59A-16-9 - Publication of nonstatutory financial statements.
Section 59A-16-10 - Defamation.
Section 59A-16-11 - Unfair discrimination prohibited; life and health insurance.
Section 59A-16-11.1 - Medical Insurance Pool Act; unfair referral.
Section 59A-16-12 - Discrimination in insurance.
Section 59A-16-12.1 - Discrimination on the basis of deterioration in health.
Section 59A-16-13 - Prohibiting sex discrimination in insurance.
Section 59A-16-13.1 - Craniomandibular and temporomandibular joint disorders.
Section 59A-16-13.2 - Discrimination on the basis of blindness.
Section 59A-16-14 - Coercion of business prohibited; notice required; charges prohibited.
Section 59A-16-17 - Discrimination, rebates and certain inducements prohibited; other coverages.
Section 59A-16-18 - Receipt of rebates and inducements; penalty.
Section 59A-16-19 - Monopolistic practices prohibited.
Section 59A-16-20 - Unfair claims practices defined and prohibited.
Section 59A-16-21.1 - Health plan requirements.
Section 59A-16-21.3 - Health care providers; surprise billing prohibited.
Section 59A-16-22 - Record of complaints required.
Section 59A-16-23 - False applications, claims, proofs of loss.
Section 59A-16-24 - Illegal dealing in premiums; excess charges for coverage.
Section 59A-16-25 - Knowledge of insurer of prohibited acts.
Section 59A-16-26 - Insurer name; deceptive use prohibited.
Section 59A-16-27 - Desist orders for prohibited practices.
Section 59A-16-28 - Procedure as to undefined practices.