§ 59A-47-1 Short title
§ 59A-47-2 Purpose; exemptions
§ 59A-47-3 Definitions
§ 59A-47-4 Organization; profit corporations prohibited; merger and consolidation of health care plans
§ 59A-47-5 Qualifications for health care plan authority
§ 59A-47-6 Preliminary permit for solicitations
§ 59A-47-7 Escrow of preliminary premiums
§ 59A-47-8 Certificate of authority required; application and conditions; exceptions
§ 59A-47-9 Issuance and denial of initial certificate of authority
§ 59A-47-10 Trust deposit
§ 59A-47-11 Expiration, continuance of certificate of authority
§ 59A-47-12 Suspension, revocation or refusal to continue certificate of authority
§ 59A-47-13 Service of process; superintendent as attorney
§ 59A-47-14 Annual statement
§ 59A-47-15 Assets
§ 59A-47-16 Reserves
§ 59A-47-17 Examination
§ 59A-47-18 Investments
§ 59A-47-19 Limitation upon acquisition and administration expenses
§ 59A-47-20 Conflicts of interest as to certain transactions
§ 59A-47-21 Joint coverage, reinsurance
§ 59A-47-22 Transfer of subscribership
§ 59A-47-23 Subscriber contracts; coverage period
§ 59A-47-24 Subscriber contracts; requirements and provisions
§ 59A-47-25 Subscriber contracts; filing, approval
§ 59A-47-26 Premium rates; filing and approval
§ 59A-47-27 Coverage for newly born children, maternity transport, home health care
§ 59A-47-27.1 Coverage of circumcision for newborn males
§ 59A-47-28 Coverage for service of chiropractor
§ 59A-47-28.1 Coverage for service of certified nurse-midwives and registered lay midwives
§ 59A-47-28.2 Doctor of oriental medicine discrimination prohibited
§ 59A-47-28.3 Provider discrimination prohibited
§ 59A-47-28.4 Coverage for collaborative practice; dental therapists;
§ 59A-47-29 Settlement of disputes; appeal
§ 59A-47-30 Licensed insurance producers required; qualifications, licensing procedures and conditions
§ 59A-47-31 Rehabilitation, liquidation or dissolution
§ 59A-47-32 Unauthorized contract or adjustment transactions;
§ 59A-47-33 Other provisions applicable
§ 59A-47-34 Continuation of coverage and conversion rights; health care plans
§ 59A-47-35 Alcohol dependency coverage
§ 59A-47-36 Nonprofit health care plans; contract or certificate provisions relating to individuals who are eligible for medical benefits under the medicaid program
§ 59A-47-37 Coverage of children
§ 59A-47-37.1 Hearing aid coverage for children required
§ 59A-47-38 Coverage for medical diets for genetic inborn errors of metabolism
§ 59A-47-39 Employer utilization and loss experience availability
§ 59A-47-40 Maximum age of dependent
§ 59A-47-41 Coverage of alpha-fetoprotein IV screening test
§ 59A-47-41.1 Prior authorization for gynecological or obstetrical ultrasounds prohibited
§ 59A-47-42 Coverage of part-time employees
§ 59A-47-43 Coverage of colorectal cancer screening
§ 59A-47-44 General anesthesia and hospitalization for dental surgery
§ 59A-47-45 Coverage for autism spectrum disorder diagnosis and treatment
§ 59A-47-45.1 Coverage for orally administered anticancer medications; limits on patient costs
§ 59A-47-45.2 Coverage of prescription eye drop refills
§ 59A-47-45.3 Coverage for telemedicine services
§ 59A-47-45.4 Prescription drugs; prohibited formulary changes;
§ 59A-47-45.5 Coverage for contraception
§ 59A-47-45.6 Coverage exclusion. (Contingent repeal. See note.)
§ 59A-47-45.7 Heart artery calcium scan coverage
§ 59A-47-45.8 Coverage for individuals with diabetes
§ 59A-47-45.9 Biomarker testing coverage
§ 59A-47-45.10 Calculating a subscriber’s cost-sharing obligation for prescription drug coverage
§ 59A-47-47 Prescription drug prior authorization protocols
§ 59A-47-47.1 Prescription drug coverage; step therapy protocols;
§ 59A-47-47.2 Pharmacist prescriptive authority services;
§ 59A-47-48 Pharmacy benefit; prescription synchronization
§ 59A-47-49 Provider credentialing; requirements; deadline
§ 59A-47-50 Physical rehabilitation services; limits on cost sharing
§ 59A-47-51 Behavioral health services; elimination of cost sharing
§ 59A-47-52 Anatomical gift nondiscrimination
§ 59A-47-53 Diagnostic and supplemental breast examinations
§ 59A-47-54 Chiropractic physician services; limits on cost sharing and coinsurance. (Effective January 1, 2024.)
§ 59A-47-55 Sexually transmitted infection care; cost sharing eliminated
§ 59A-47-56 Definitions
§ 59A-47-57 Benefits required
§ 59A-47-58 Parity for coverage of mental health or substance use disorder services
§ 59A-47-59 Provider network adequacy
§ 59A-47-60 Utilization review of mental health or substance use disorder services
§ 59A-47-61 Prohibited exclusions of coverage for mental health or substance use disorder services
§ 59A-47-62 Level of care determinations for the provision of mental health or substance use disorder services
§ 59A-47-63 Coordination of care
§ 59A-47-64 Confidentiality provisions
§ 59A-47-65 Exceptions
§ 59A-47-66 Medical necessity and nondiscrimination standards for coverage of prosthetics and orthotics. (Effective January 1, 2024.)

Terms Used In New Mexico Statutes > Chapter 59A > Article 47 - Nonprofit Health Care Plans

  • 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.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Continuance: Putting off of a hearing ot trial until a later time.
  • 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.
  • Dependent: A person dependent for support upon another.
  • Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
  • Escrow: Money given to a third party to be held for payment until certain conditions are met.
  • 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.
  • Fraud: Intentional deception resulting in injury to another.
  • Gift: A voluntary transfer or conveyance of property without consideration, or for less than full and adequate consideration based on fair market value.
  • 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.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • 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.
  • 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.
  • Service of process: The service of writs or summonses to the appropriate party.
  • 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.