The provisions of the Insurance Code [Chapter 59A NMSA 1978] other than Chapter 59A, Article 47 NMSA 1978 shall not apply to health care plans except as expressly provided in the Insurance Code and that article. To the extent reasonable and not inconsistent with the provisions of that article, the following articles and provisions of the Insurance Code shall also apply to health care plans, their promoters, sponsors, directors, officers, employees, agents, solicitors and other representatives; and, for the purposes of such applicability, a health care plan may therein be referred to as an "insurer":
A. Chapter 59A, Article 1 NMSA 1978;
B. Chapter 59A, Article 2 NMSA 1978;
C. Chapter 59A, Article 4 NMSA 1978;
D. Subsection C of Section 59A-5-22 NMSA 1978;
E. Sections 59A-6-2 through 59A-6-4 and 59A-6-6 NMSA 1978;
F. Section 59A-7-11 NMSA 1978;
G. Chapter 59A, Article 8 NMSA 1978;
H. Chapter 59A, Article 10 NMSA 1978;
I. Section 59A-12-22 NMSA 1978;
J. Chapter 59A, Article 16 NMSA 1978;
K. Chapter 59A, Article 18 NMSA 1978;
L. Chapter 59A, Article 19 NMSA 1978;
M. Subsections B through E of Section 59A-22-5 NMSA 1978;
N. Section 59A-22-14 NMSA 1978;
O. Section 59A-22-34.1 NMSA 1978;
P. Section 59A-22-39 NMSA 1978;
Q. Section 59A-22-40 NMSA 1978;
R. Section 59A-22-40.1 NMSA 1978;
S. Section 59A-22-41 NMSA 1978;
T. Section 59A-22-42 NMSA 1978;
U. Section 59A-22-43 NMSA 1978;
V. Section 59A-22-44 NMSA 1978;
W. Section 59A-22-50 NMSA 1978;
X. Sections 59A-34-7 through 59A-34-13, 59A-34-17, 59A-34-23, 59A-34-33, 59A-34-40 through 59A-34-42 and 59A-34-44 through 59A-34-46 NMSA 1978;
Y. the Insurance Holding Company Law Chapter 59A, Article 37 NMSA 1978, except Section 59A-37-7 NMSA 1978;
Z. Section 59A-46-15 NMSA 1978;
AA. the Patient Protection Act [Chapter 59A, Article 57 NMSA 1978]; and
BB. the Surprise Billing Protection Act [59A-57A-1 to 59A-57A-13 NMSA 1978].
History: Laws 1984, ch. 127, § 879.32; 1988, ch. 89, § 5; 1990, ch. 5, § 4; 1992, ch. 56, § 4; 1993, ch. 320, § 103; 1994, ch. 64, § 10; 1994, ch. 75, § 34; 1997, ch. 7, § 4; 1997, ch. 248, § 3; 1997, ch. 255, § 4; 1998, ch. 107, § 14; 1999, ch. 289, § 36; 2001, ch. 14, § 4; 2001, ch. 297, § 6; 2003, ch. 337, § 5; 2007, ch. 278, § 4; 2009, ch. 212, § 5; 2021, ch. 108, § 29.
The 2021 amendment, effective July 1, 2021, revised the list of articles and provisions of the Insurance Code that also apply to health care plans; in Subsection L, deleted "the Policy Language Simplification Law" and added "Chapter 59A, Article 19 NMSA 1978"; added a new Subsection W and redesignated former Subsections W through Z as Subsections X through AA, respectively; and added Subsection BB.
The 2009 amendment, effective June 19 , 2009, added Subsection U.
The 2007 amendment, effective June 15, 2007, added Subsection R.
The 2003 amendment, effective June 20, 2003, deleted the references to Chapter 59A, Article 19, Section 59A-22-2.1, and Chapter 59A, Article 37 being former Subsections L, M and U; inserted present Subsections L, S and T redesignated the subsequent subsections accordingly; and inserted "The Insurance Holding Company Law" in Subsection V.
The 2001 amendment, effective June 15, 2001, added a new Subsection K; redesignated former Subsections K and L, as Subsections L and M; substituted "the Policy Language Simplification Law" for "Chapter 59A, Article 19 NMSA 1978"; deleted former Subsection M, which listed Section 59A-22-2.1; and in Subsection U, substituted "the Insurance Holding Company Law" for "Chapter 59A, Article 37 NMSA 1978".
The 1999 amendment, effective June 18, 1999, added Subsection M and redesignated the following subsections accordingly, and in Subsection T, deleted "59A-34-9" and inserted "59A-34-7", "59A-34-17", and "59A-34-33, 59A-34-40 through 59A-34-42 and 59A-34-44 through 59A-34-46".
The 1998 amendment, effective July 1, 1998, added Subsection N, redesignated the following subsections accordingly, added Subsection V, and made a minor stylistic change in the section.
The 1997 amendment, effective January 1, 1998, added Subsection Q and redesignated former Subsections Q through S as Subsections R through T.
The 1994 amendment, effective January 1, 1995, inserted a new Subsection M and redesignated former Subsections M to R as Subsections N to S.
The 1993 amendment, effective June 18, 1993, rewrote the introductory language; substituted references to "section" for references to "chapter" in Subsections N and O; deleted "and" at the end of Subsection N; and added Subsections P through R.
The 1992 amendment, effective May 20, 1992, added Subsection O.
Structure New Mexico Statutes
Article 47 - Nonprofit Health Care Plans
Section 59A-47-1 - Short title.
Section 59A-47-2 - Purpose; exemptions.
Section 59A-47-3 - Definitions.
Section 59A-47-5 - Qualifications for health care plan authority.
Section 59A-47-6 - Preliminary permit for solicitations.
Section 59A-47-7 - Escrow of preliminary premiums.
Section 59A-47-8 - Certificate of authority required; application and conditions; exceptions.
Section 59A-47-9 - Issuance and denial of initial certificate of authority.
Section 59A-47-10 - Trust deposit.
Section 59A-47-11 - Expiration, continuance of certificate of authority.
Section 59A-47-12 - Suspension, revocation or refusal to continue certificate of authority.
Section 59A-47-13 - Service of process; superintendent as attorney.
Section 59A-47-14 - Annual statement.
Section 59A-47-17 - Examination.
Section 59A-47-18 - Investments.
Section 59A-47-19 - Limitation upon acquisition and administration expenses.
Section 59A-47-20 - Conflicts of interest as to certain transactions.
Section 59A-47-21 - Joint coverage, reinsurance.
Section 59A-47-22 - Transfer of subscribership.
Section 59A-47-23 - Subscriber contracts; coverage period.
Section 59A-47-24 - Subscriber contracts; requirements and provisions.
Section 59A-47-25 - Subscriber contracts; filing, approval.
Section 59A-47-26 - Premium rates; filing and approval.
Section 59A-47-27 - Coverage for newly born children, maternity transport, home health care.
Section 59A-47-27.1 - Coverage of circumcision for newborn males.
Section 59A-47-28 - Coverage for service of chiropractor.
Section 59A-47-28.1 - Coverage for service of certified nurse-midwives and registered lay midwives.
Section 59A-47-28.2 - Doctor of oriental medicine discrimination prohibited.
Section 59A-47-28.3 - Provider discrimination prohibited.
Section 59A-47-28.4 - Coverage for collaborative practice; dental therapists; dental hygienists.
Section 59A-47-29 - Settlement of disputes; appeal.
Section 59A-47-31 - Rehabilitation, liquidation or dissolution.
Section 59A-47-32 - Unauthorized contract or adjustment transactions; penalty.
Section 59A-47-33 - Other provisions applicable.
Section 59A-47-34 - Continuation of coverage and conversion rights; health care plans.
Section 59A-47-35 - Alcohol dependency coverage.
Section 59A-47-37 - Coverage of children. (Effective July 1, 2020.)
Section 59A-47-37.1 - Hearing aid coverage for children required.
Section 59A-47-38 - Coverage for medical diets for genetic inborn errors of metabolism.
Section 59A-47-39 - Employer utilization and loss experience availability.
Section 59A-47-40 - Maximum age of dependent.
Section 59A-47-41 - Coverage of alpha-fetoprotein IV screening test.
Section 59A-47-41.1 - Prior authorization for gynecological or obstetrical ultrasounds prohibited.
Section 59A-47-42 - Coverage of part-time employees.
Section 59A-47-43 - Coverage of colorectal cancer screening.
Section 59A-47-44 - General anesthesia and hospitalization for dental surgery.
Section 59A-47-45 - Coverage for autism spectrum disorder diagnosis and treatment.
Section 59A-47-45.2 - Coverage of prescription eye drop refills.
Section 59A-47-45.3 - Coverage for telemedicine services.
Section 59A-47-45.4 - Prescription drugs; prohibited formulary changes; notice requirements.
Section 59A-47-45.5 - Coverage for contraception.
Section 59A-47-45.6 - Coverage exclusion. (Contingent repeal. See note.)
Section 59A-47-45.7 - Heart artery calcium scan coverage.
Section 59A-47-47 - Prescription drug prior authorization protocols.
Section 59A-47-47.2 - Pharmacist prescriptive authority services; reimbursement parity.
Section 59A-47-48 - Pharmacy benefit; prescription synchronization.
Section 59A-47-49 - Provider credentialing; requirements; deadline.
Section 59A-47-50 - Physical rehabilitation services; limits on cost sharing.