A. Any rehabilitation, liquidation or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation or conservation of an insurer and shall be conducted under the supervision of the superintendent pursuant to the law governing the rehabilitation, liquidation or conservation of insurers. The superintendent may apply for an order directing him to rehabilitate, liquidate or conserve a health maintenance organization upon any one or more grounds set out in Chapter 59A, Article 41 NMSA 1978 or when in his opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or to the people of this state. Enrollees shall have the same priority in the event of liquidation or rehabilitation as the law provides to policyholders of an insurer.
B. For purpose of determining the priority of distribution of general assets, claims of enrollees and enrollees' beneficiaries shall have the same priority as established by Subsection C of Section 59A-41-44 NMSA 1978 for policyholders and beneficiaries of insureds of insurance companies. If an enrollee is liable to any provider for services provided pursuant to and covered by the health care plan, that liability shall have the status of an enrollee claim for distribution of general assets.
C. Any provider who is obligated by statute or agreement to hold enrollees harmless from liability for services provided pursuant to and covered by a health care plan shall have a priority of distribution of the general assets immediately following that of enrollees and enrollees' beneficiaries as described in Subsection B of this section and immediately preceding the priority of distribution described in Subsection D of Section 59A-41-44 NMSA 1978.
History: 1978 Comp., § 59A-46-21, enacted by Laws 1993, ch. 266, § 21.
Repeals and reenactments. — Laws 1993, ch. 266, § 43 repealed former 59A-46-21 NMSA 1978, as enacted by Laws 1984, ch. 127, § 868, related to fees, and Laws 1993, ch. 266, § 21 enacted a new section, effective January 1, 1994.
Structure New Mexico Statutes
Article 46 - Health Maintenance Organizations
Section 59A-46-1 - Short title.
Section 59A-46-2 - Definitions.
Section 59A-46-3 - Establishment of health maintenance organizations.
Section 59A-46-4 - Issuance of certificate of authority.
Section 59A-46-5 - Powers of health maintenance organizations.
Section 59A-46-6 - Fiduciary responsibilities; fidelity bond.
Section 59A-46-7 - Quality assurance program.
Section 59A-46-8 - Requirements for group contract, individual contract and evidence of coverage.
Section 59A-46-9 - Annual report.
Section 59A-46-10 - Information to enrollees or subscribers.
Section 59A-46-11 - Grievance procedures.
Section 59A-46-12 - Investments.
Section 59A-46-13 - Protection against insolvency.
Section 59A-46-14 - Uncovered expenditures insolvency deposit.
Section 59A-46-15 - Enrollment period; replacement coverage in the event of insolvency.
Section 59A-46-16 - Filing requirements for rating information.
Section 59A-46-17 - Regulation of health maintenance organization insurance producers.
Section 59A-46-18 - Powers of insurers.
Section 59A-46-19 - Examinations.
Section 59A-46-20 - Suspension or revocation of certificate of authority.
Section 59A-46-21 - Rehabilitation, liquidation or conservation of health maintenance organizations.
Section 59A-46-22 - Summary orders and supervision.
Section 59A-46-22.1 - Repealed.
Section 59A-46-23 - Regulations.
Section 59A-46-25 - Penalties and enforcement.
Section 59A-46-26 - Filings and reports as public documents.
Section 59A-46-26.1 - Employer utilization and loss experience availability.
Section 59A-46-27 - Confidentiality of medical information and limitation of liability.
Section 59A-46-28 - Authority to contract.
Section 59A-46-30 - Statutory construction and relationship to other laws.
Section 59A-46-31 - Coordination of benefits.
Section 59A-46-32 - Continuation of coverage and conversion rights; health care plans.
Section 59A-46-32.1 - Recompiled.
Section 59A-46-33 - Governing body.
Section 59A-46-34 - Prohibited practices.
Section 59A-46-35 - Provider discrimination prohibited.
Section 59A-46-36 - Doctor of oriental medicine; discrimination prohibited.
Section 59A-46-37 - Coverage for adopted children.
Section 59A-46-38 - Newly born children coverage.
Section 59A-46-38.1 - Coverage of children.
Section 59A-46-38.2 - Childhood immunization coverage required.
Section 59A-46-38.3 - Maximum age of dependent.
Section 59A-46-38.4 - Coverage of circumcision for newborn males.
Section 59A-46-38.5 - Hearing aid coverage for children required.
Section 59A-46-39 - Maternity transport required.
Section 59A-46-40 - Home health care service option required.
Section 59A-46-41 - Coverage for mammograms.
Section 59A-46-41.2 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 59A-46-42 - Coverage for cytologic and human papillomavirus screening.
Section 59A-46-42.1 - Coverage for the human papillomavirus vaccine.
Section 59A-46-43 - Coverage for individuals with diabetes.
Section 59A-46-43.2 - Coverage for medical diets for genetic inborn errors of metabolism.
Section 59A-46-44 - Coverage for contraception.
Section 59A-46-45 - Coverage for smoking cessation treatment.
Section 59A-46-46 - Coverage of alpha-fetoprotein IV screening test.
Section 59A-46-47 - Coverage of part-time employees.
Section 59A-46-48 - Coverage of colorectal cancer screening.
Section 59A-46-49 - General anesthesia and hospitalization for dental surgery.
Section 59A-46-50 - Coverage for autism spectrum disorder diagnosis and treatment.
Section 59A-46-50.2 - Coverage of prescription eye drop refills.
Section 59A-46-50.3 - Coverage for telemedicine services.
Section 59A-46-50.4 - Prescription drugs; prohibited formulary changes; notice requirements.
Section 59A-46-52 - Prescription drug prior authorization protocols.
Section 59A-46-52.2 - Pharmacist prescriptive authority services; reimbursement parity.
Section 59A-46-53 - Pharmacy benefits; prescription synchronization.
Section 59A-46-54 - Provider credentialing; requirements; deadline.
Section 59A-46-55 - Coverage exclusion. (Contingent repeal. See note below.)
Section 59A-46-56 - Physical rehabilitation services; limits on cost sharing.