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§ 13-7-25 NMSA 1978

Coverage for individuals with diabetes; insulin for diabetes; cost-sharing cap

Known as the Health Care Purchasing Act

The act spans §§ 13-7-1 to 13-7-9 (48 sections).

Laws 2020, ch. 36, § 1; 2023, ch. 50, § 1.

A. Group health care coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act shall cap the amount an insured is required to pay for a preferred formulary prescription insulin drug or a medically necessary alternative at an amount not to exceed a total of twenty-five dollars ($25.00) per thirty-day supply and shall provide coverage for individuals with diabetes as required by law for each health care insurer, including:

(1) group health insurance policies, health care plans, certificates of health insurance and managed health care plans delivered or issued for delivery in New Mexico;

(2) group health plans provided through a cooperative;

(3) group health maintenance organization contracts delivered or issued for delivery in New Mexico; and

(4) health benefit plans.

B. As used in this section, "health care insurer" means a person who provides health insurance in this state, including a licensed insurance company, a licensed fraternal benefit society, a prepaid hospital or medical service plan, a health maintenance organization, a managed care organization, a nonprofit health care organization, a multiple-employer welfare arrangement or any other person providing a plan of health insurance subject to state regulation.

Official source: NMOneSource (New Mexico Compilation Commission). Reproduced from public-domain New Mexico statutes; confirm against the official source for the current text. Not legal advice.