A. A blanket or group health insurance policy or contract that is delivered, issued for delivery or renewed in this state and that provides coverage for gynecological or obstetrical ultrasounds shall not require prior authorization for gynecological or obstetrical ultrasounds.
B. Nothing in this section shall be construed to require payment for a gynecological or obstetrical ultrasound that is not:
(1) medically necessary; or
(2) a covered benefit.
C. As used in this section, "prior authorization" means advance approval that is required by blanket or group health insurance policy or contract as a condition precedent to payment for medical care or related benefits rendered to a covered person, including prospective or utilization review conducted prior to the provision of covered medical care or related benefits.
History: Laws 2019, ch. 182, § 4.
Emergency clauses. — Laws 2019, ch. 182, § 7 contained an emergency clause and was approved April 3, 2019.
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.