A. The provisions of the Insurance Code [N.M. Stat. Ann. Chapter 59A] other than N.M. Stat. Ann. Chapter 59A, Article 46 shall not apply to health maintenance organizations 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 maintenance organizations and their promoters, sponsors, directors, officers, employees, agents, solicitors and other representatives. For the purposes of such applicability, a health maintenance organization may therein be referred to as an “insurer”:

Terms Used In New Mexico Statutes 59A-46-30

  • Fraud: Intentional deception resulting in injury to another.

(1)     N.M. Stat. Ann. Chapter 59A, Article 1; (2)     N.M. Stat. Ann. Chapter 59A, Article 2; (3)     N.M. Stat. Ann. Chapter 59A, Article 4;

(4)     Subsection C of Section 59A-5-22 N.M. Stat. Ann.;

(5)     Sections 59A-6-2 through 59A-6-4 and 59A-6-6 N.M. Stat. Ann.; (6)     N.M. Stat. Ann. Chapter 59A, Article 8;

(7)     N.M. Stat. Ann. Chapter 59A, Article 10; (8)     N.M. Stat. Ann. Chapter 59A, Article 16;

(9)     the Domestic Abuse Insurance Protection Act N.M. Stat. Ann. § 59A-16B-1 to 59A-16B-10;

(10)    the Insurance Fraud Act [N.M. Stat. Ann. Chapter 59A, Article 16C]; (11)    N.M. Stat. Ann. Chapter 59A, Article 18;

1978];

(12)    the Policy Language Simplification Law [59A-19-1 to 59A-19-7 NMSA (13)    Section 59A-22-14 N.M. Stat. Ann.;

1978];

(14)    the Health Insurance Portability Act [Chapter 59A, Article 23E NMSA (15)    Sections 59A-34-2, 59A-34-7 through 59A-34-13, 59A-34-17, 59A-34-23, 59A-34-33, 59A-34-36, 59A-34-37, 59A-34-40 through 59A-34-42 and 59A-34-44 through 59A-34-46 N.M. Stat. Ann.;

1978];

(16)    the Insurance Holding Company Law [Chapter 59A, Article 37 NMSA (17)    the Patient Protection Act [N.M. Stat. Ann. Chapter 59A, Article 57]; and

1978].

(18)    the Surprise Billing Protection Act [59A-57A-1 to 59A-57A-13 NMSA B. Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, shall not be construed as violating any provision of law relating to solicitation or advertising by health professionals, but health professionals shall be individually subject to the laws, rules and ethical provisions governing their individual professions.

C. Any health maintenance organization authorized under the provisions of the Health Maintenance Organization Law shall not be deemed to be practicing medicine and shall be exempt from the provisions of laws relating to the practice of medicine.