§ 59A-46-1 Short title
§ 59A-46-2 Definitions
§ 59A-46-3 Establishment of health maintenance organizations
§ 59A-46-4 Issuance of certificate of authority
§ 59A-46-5 Powers of health maintenance organizations
§ 59A-46-6 Fiduciary responsibilities; fidelity bond
§ 59A-46-7 Quality assurance program
§ 59A-46-8 Requirements for group contract, individual contract and evidence of coverage
§ 59A-46-9 Annual report
§ 59A-46-10 Information to enrollees or subscribers
§ 59A-46-11 Grievance procedures
§ 59A-46-12 Investments
§ 59A-46-13 Protection against insolvency
§ 59A-46-14 Uncovered expenditures insolvency deposit
§ 59A-46-15 Enrollment period; replacement coverage in the event of insolvency
§ 59A-46-16 Filing requirements for rating information
§ 59A-46-17 Regulation of health maintenance organization insurance producers
§ 59A-46-18 Powers of insurers
§ 59A-46-19 Examinations
§ 59A-46-20 Suspension or revocation of certificate of authority
§ 59A-46-21 Rehabilitation, liquidation or conservation of health maintenance organizations
§ 59A-46-22 Summary orders and supervision
§ 59A-46-23 Regulations
§ 59A-46-24 Fees
§ 59A-46-25 Penalties and enforcement
§ 59A-46-26 Filings and reports as public documents
§ 59A-46-26.1 Employer utilization and loss experience availability
§ 59A-46-27 Confidentiality of medical information and limitation of liability
§ 59A-46-28 Authority to contract
§ 59A-46-29 Health maintenance organizations; contract or certificate provisions relating to individuals who are eligible for medical benefits under the medicaid program
§ 59A-46-30 Statutory construction and relationship to other laws
§ 59A-46-31 Coordination of benefits
§ 59A-46-32 Continuation of coverage and conversion rights; health care plans
§ 59A-46-33 Governing body
§ 59A-46-34 Prohibited practices
§ 59A-46-35 Provider discrimination prohibited
§ 59A-46-36 Doctor of oriental medicine; discrimination prohibited
§ 59A-46-37 Coverage for adopted children
§ 59A-46-38 Newly born children coverage
§ 59A-46-38.1 Coverage of children
§ 59A-46-38.2 Childhood immunization coverage required
§ 59A-46-38.3 Maximum age of dependent
§ 59A-46-38.4 Coverage of circumcision for newborn males
§ 59A-46-38.5 Hearing aid coverage for children required
§ 59A-46-39 Maternity transport required
§ 59A-46-40 Home health care service option required
§ 59A-46-41 Coverage for mammograms
§ 59A-46-41.1 Mastectomies and lymph node dissection; minimum hospital stay coverage required
§ 59A-46-41.2 Prior authorization for gynecological or obstetrical ultrasounds prohibited
§ 59A-46-41.3 Diagnostic and supplemental breast examinations
§ 59A-46-42 Coverage for cytologic and human papillomavirus screening
§ 59A-46-42.1 Coverage for the human papillomavirus vaccine
§ 59A-46-43 Coverage for individuals with diabetes
§ 59A-46-43.2 Coverage for medical diets for genetic inborn errors of metabolism
§ 59A-46-44 Coverage for contraception
§ 59A-46-45 Coverage for smoking cessation treatment
§ 59A-46-46 Coverage of alpha-fetoprotein IV screening test
§ 59A-46-47 Coverage of part-time employees
§ 59A-46-48 Coverage of colorectal cancer screening
§ 59A-46-49 General anesthesia and hospitalization for dental surgery
§ 59A-46-50 Coverage for autism spectrum disorder diagnosis and treatment
§ 59A-46-50.1 Coverage for orally administered anticancer medications; limits on patient costs
§ 59A-46-50.2 Coverage of prescription eye drop refills
§ 59A-46-50.3 Coverage for telemedicine services
§ 59A-46-50.4 Prescription drugs; prohibited formulary changes;
§ 59A-46-50.5 Heart artery calcium scan coverage
§ 59A-46-52 Prescription drug prior authorization protocols
§ 59A-46-52.1 Prescription drug coverage; step therapy protocols;
§ 59A-46-52.2 Pharmacist prescriptive authority services;
§ 59A-46-52.3 Calculating an enrollee’s cost-sharing obligation for prescription drug coverage
§ 59A-46-53 Pharmacy benefits; prescription synchronization
§ 59A-46-54 Provider credentialing; requirements; deadline
§ 59A-46-55 Coverage exclusion. (Contingent repeal. See note below.)
§ 59A-46-56 Physical rehabilitation services; limits on cost sharing
§ 59A-46-57 Behavioral health services; elimination of cost sharing
§ 59A-46-58 Anatomical gift nondiscrimination
§ 59A-46-59 Chiropractic physician services; limits on cost sharing and coinsurance. (Effective January 1, 2024.)
§ 59A-46-60 Sexually transmitted infection care; cost sharing eliminated
§ 59A-46-61 Definitions
§ 59A-46-62 Benefits required
§ 59A-46-63 Parity for coverage of mental health or substance use disorder services
§ 59A-46-64 Provider network adequacy
§ 59A-46-65 Utilization review of mental health or substance use disorder services
§ 59A-46-66 Prohibited exclusions of coverage for mental health or substance use disorder services
§ 59A-46-67 Level of care determinations for the provision of mental health or substance use disorder services
§ 59A-46-68 Coordination of care
§ 59A-46-69 Confidentiality provisions
§ 59A-46-70 Exceptions
§ 59A-46-71 Biomarker testing coverage
§ 59A-46-72 Medical necessity and nondiscrimination standards for coverage of prosthetics and orthotics. (Effective January 1, 2024.)

Terms Used In New Mexico Statutes > Chapter 59A > Article 46 - Health Maintenance Organizations

  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Contract: A legal written agreement that becomes binding when signed.
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Dependent: A person dependent for support upon another.
  • Discovery: Lawyers' examination, before trial, of facts and documents in possession of the opponents to help the lawyers prepare for trial.
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • Fair market value: The price at which an asset would change hands in a transaction between a willing, informed buyer and a willing, informed seller.
  • Fiduciary: A trustee, executor, or administrator.
  • Fraud: Intentional deception resulting in injury to another.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Power of attorney: A written instrument which authorizes one person to act as another's agent or attorney. The power of attorney may be for a definite, specific act, or it may be general in nature. The terms of the written power of attorney may specify when it will expire. If not, the power of attorney usually expires when the person granting it dies. Source: OCC
  • Precedent: A court decision in an earlier case with facts and law similar to a dispute currently before a court. Precedent will ordinarily govern the decision of a later similar case, unless a party can show that it was wrongly decided or that it differed in some significant way.
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • Statute: A law passed by a legislature.
  • Subpoena: A command to a witness to appear and give testimony.
  • Testify: Answer questions in court.
  • Trustee: A person or institution holding and administering property in trust.