A. A group or blanket health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state 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, § 3.
Effective dates. — Laws 2019, ch. 188, § 6 made Laws 2019, ch. 188 effective January 1, 2020.
Structure New Mexico Statutes
Article 23 - Group and Blanket Health Insurance Contracts
Section 59A-23-1 - Scope of article.
Section 59A-23-2 - Blanket health insurance.
Section 59A-23-3 - Group health insurance.
Section 59A-23-3.1 - Group insurance reports required.
Section 59A-23-4 - Other provisions applicable.
Section 59A-23-5 - Extended disability benefit.
Section 59A-23-6 - Alcohol dependency coverage.
Section 59A-23-6.1 - Coverage of alpha-fetoprotein IV screening test.
Section 59A-23-6.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 59A-23-7.2 - Coverage of children.
Section 59A-23-7.3 - Maximum age of dependent.
Section 59A-23-7.4 - Coverage of circumcision for newborn males.
Section 59A-23-7.5 - Coverage of part-time employees.
Section 59A-23-7.6 - Coverage of colorectal cancer screening.
Section 59A-23-7.7 - General anesthesia and hospitalization for dental surgery.
Section 59A-23-7.8 - Hearing aid coverage for children required.
Section 59A-23-7.9 - Coverage for autism spectrum disorder diagnosis and treatment.
Section 59A-23-7.11 - Coverage of prescription eye drop refills.
Section 59A-23-7.12 - Coverage for telemedicine services.
Section 59A-23-7.13 - Prescription drugs; prohibited formulary changes; notice requirements.
Section 59A-23-7.14 - Coverage for contraception.
Section 59A-23-7.15 - Coverage exclusion. (Contingent repeal. See note.)
Section 59A-23-7.16 - Heart artery calcium scan coverage.
Section 59A-23-8 - Group formed to purchase health insurance; limitations.
Section 59A-23-10 - Employer utilization and loss data availability.
Section 59A-23-11 - Private health insurance cooperatives; incorporation.
Section 59A-23-12 - Prescription drug prior authorization protocols.
Section 59A-23-12.2 - Pharmacist prescriptive authority services; reimbursement parity.
Section 59A-23-13 - Pharmacy benefits; prescription synchronization.
Section 59A-23-14 - Provider credentialing; requirements; deadline.
Section 59A-23-15 - Physical rehabilitation services; limits on cost sharing.