New Mexico Statutes
Article 22 - Health Insurance Contracts
Section 59A-22-34 - Newly born children coverage.

A. All individual and group health insurance policies delivered or issued for delivery in this state and which provide coverage on an expense-incurred basis for a family member of the insured shall, as to such family members' coverage, also provide that the health insurance benefits applicable for children shall be payable with respect to a newly born child of the insured from the moment of birth.
B. All individual and group health insurance policies delivered or issued for delivery in this state that do not provide coverage for a family member of the insured shall provide for an option to add to the coverage any newly born child of the insured provided that the requirements of Subsection D of this section have been met.
C. The coverage for newly born children shall consist of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities and, where necessary to protect the life of the infant, transportation, including air transport, to the nearest available tertiary care facility for newly born infants.
D. If payment of a specific premium is required to provide coverage for a child, the policy may require that a notification of birth of a newly born child and payment of the required premium must be furnished to the insurer within thirty-one days after the date of birth in order to have the coverage from birth.
E. As used in this section and in Section 59A-22-35 NMSA 1978, "tertiary care facility" means a hospital unit which provides complete perinatal care and intensive care of intrapartum and perinatal high-risk patients with responsibilities for coordination of transport, communication, education and data analysis systems for the geographic area served.
History: Laws 1984, ch. 127, § 456; 1993, ch. 169, § 1.
The 1993 amendment, effective June 18, 1993, substituted "basis" for "bases" in Subsection A; added Subsection B; redesignated former Subsections B through D as present Subsections C through E; in Subsection D, substituted "from birth" for "continue beyond such thirty-one day period" and made a minor stylistic change; and substituted "Section 59A-22-35 NMSA 1978" for "Section 457 of this article" in Subsection E.
Applicability. — Laws 1993, ch. 169, § 3 provides that the provisions of the act apply to policies, plans, contracts and certificates delivered or issued for delivery or renewed, extended or amended in the state on or after July 1, 1993.
Am. Jur. 2d, A.L.R. and C.J.S. references. — Unborn child as insured or injured person within meaning of insurance policy, 15 A.L.R.4th 548.

Structure New Mexico Statutes

New Mexico Statutes

Chapter 59A - Insurance Code

Article 22 - Health Insurance Contracts

Section 59A-22-1 - Scope of article.

Section 59A-22-2 - Form and content of policy.

Section 59A-22-3 - Required provisions.

Section 59A-22-4 - Entire contract; changes.

Section 59A-22-5 - Time limit on certain defenses.

Section 59A-22-6 - Grace period.

Section 59A-22-7 - Reinstatement.

Section 59A-22-8 - Notice of claim.

Section 59A-22-9 - Claim forms.

Section 59A-22-10 - Proofs of loss.

Section 59A-22-11 - Time of payment of claims.

Section 59A-22-12 - Payment of claims.

Section 59A-22-13 - Physical examination and autopsy.

Section 59A-22-14 - Legal actions.

Section 59A-22-15 - Change of beneficiary.

Section 59A-22-16 - Optional provisions.

Section 59A-22-17 - Change of occupation.

Section 59A-22-18 - Misstatement of age.

Section 59A-22-19 - Other insurance in this insurance company.

Section 59A-22-20 - Insurance with other insurance companies.

Section 59A-22-21 - Insurance with other insurance companies [; alternative provision].

Section 59A-22-22 - Relation of earnings to insurance.

Section 59A-22-23 - Unpaid premium.

Section 59A-22-24 - Cancellation.

Section 59A-22-25 - Conformity with state statutes.

Section 59A-22-26 - Order of certain policy provisions.

Section 59A-22-27 - Third party ownership.

Section 59A-22-28 - Requirements of other jurisdictions.

Section 59A-22-29 - Conforming to statute.

Section 59A-22-30 - Age limit.

Section 59A-22-30.1 - Maximum age of dependent.

Section 59A-22-31 - Industrial health insurance.

Section 59A-22-32 - Freedom of choice of hospital and practitioner.

Section 59A-22-32.1 - Freedom of choice.

Section 59A-22-33 - Children with disabilities; coverage continued.

Section 59A-22-34 - Newly born children coverage.

Section 59A-22-34.1 - Coverage for adopted children.

Section 59A-22-34.2 - Coverage of children.

Section 59A-22-34.3 - Childhood immunization coverage required.

Section 59A-22-34.4 - Coverage of circumcision for newborn males.

Section 59A-22-34.5 - Hearing aid coverage for children required.

Section 59A-22-35 - Maternity transport required.

Section 59A-22-36 - Home health care service option required.

Section 59A-22-37 - Repealed.

Section 59A-22-38 - Individual health insurance; policy provisions relating to individuals who are eligible for medical benefits under the medicaid program.

Section 59A-22-39 - Coverage for mammograms.

Section 59A-22-39.1 - Mastectomies and lymph node dissection; minimum hospital stay coverage required.

Section 59A-22-39.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.

Section 59A-22-40 - Coverage for cytologic and human papillomavirus screening.

Section 59A-22-40.1 - Coverage for the human papillomavirus vaccine.

Section 59A-22-41 - Coverage for individuals with diabetes.

Section 59A-22-41.1 - Coverage for medical diets for genetic inborn errors of metabolism.

Section 59A-22-42 - Coverage for prescription contraceptive drugs or devices.

Section 59A-22-43 - Required coverage of patient costs incurred in cancer clinical trials.

Section 59A-22-44 - Coverage for smoking cessation treatment.

Section 59A-22-45 - Coverage of alpha-fetoprotein IV screening test.

Section 59A-22-46 - Coverage of part-time employees.

Section 59A-22-47 - Coverage of colorectal cancer screening.

Section 59A-22-48 - General anesthesia and hospitalization for dental surgery.

Section 59A-22-49 - Coverage for autism spectrum disorder diagnosis and treatment.

Section 59A-22-49.1 - Coverage for orally administered anticancer medications; limits on patient costs.

Section 59A-22-49.2 - Coverage of prescription eye drop refills.

Section 59A-22-49.3 - Coverage for telemedicine services.

Section 59A-22-49.4 - Prescription drugs; prohibited formulary changes; notice requirements.

Section 59A-22-50 - Health insurers; direct services.

Section 59A-22-51 - Dental insurance plan; dental fees not covered; severability.

Section 59A-22-52 - Prescription drug prior authorization protocols.

Section 59A-22-53 - Pharmacy benefits; prescription synchronization.

Section 59A-22-53.1 - Prescription drug coverage; step therapy protocols; clinical review criteria; exceptions.

Section 59A-22-53.2 - Pharmacist prescriptive authority services; reimbursement parity.

Section 59A-22-54 - Provider credentialing; requirements; deadline.

Section 59A-22-55 - Coverage exclusion. (Contingent repeal. See note.)

Section 59A-22-56 - Physical rehabilitation services; limits on cost sharing.

Section 59A-22-57 - Behavioral health services; elimination of cost sharing. (Effective January 1, 2022.)