SENATE BILL 443

57th legislature - STATE OF NEW MEXICO - first session, 2025

INTRODUCED BY

Martin Hickey

 

 

 

 

 

AN ACT

RELATING TO INSURANCE; AMENDING THE HEALTH CARE PURCHASING ACT AND SECTIONS OF THE NEW MEXICO INSURANCE CODE TO PROHIBIT COST SHARING FOR CHOLESTEROL-LOWERING DRUGS.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO:

     SECTION 1. A new section of the Health Care Purchasing Act is enacted to read:

     "[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--

          A. Group health coverage, including any form of self-insurance, offered, issued or renewed under the Health Care Purchasing Act that provides coverage for cholesterol-lowering drugs shall not impose cost sharing on those drugs.

          B. For the purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of an enrollee other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of a group health plan."

     SECTION 2. A new section of Chapter 59A, Article 22 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--

          A. An individual or group health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state that provides coverage for cholesterol-lowering drugs shall not impose cost sharing on those drugs.

          B. For the purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of the insured other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of an individual or group health insurance policy, health care plan or certificate of health insurance."

     SECTION 3. A new section of Chapter 59A, Article 23 NMSA is enacted to read:

     "[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--

          A. A group or blanket health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state that provides coverage for cholesterol-lowering drugs shall not impose cost sharing on those drugs.

          B. For the purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of a covered person other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of a group or blanket health insurance policy, health care plan or certificate of health insurance."

     SECTION 4. A new section of the Health Maintenance Organization Law is enacted to read:

     "[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--

          A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state that provides coverage for cholesterol-lowering drugs shall not impose cost sharing on those drugs.

          B. For the purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of an enrollee other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of an individual or group health maintenance organization contract."

     SECTION 5. A new section of the Nonprofit Health Care Plan Law is enacted to read:

     "[NEW MATERIAL] COVERAGE FOR CHOLESTEROL-LOWERING DRUGS.--

          A. An individual or group health care plan that is delivered, issued for delivery or renewed in this state that provides coverage for cholesterol-lowering drugs shall not impose cost sharing on those drugs.

          B. For the purposes of this section, "cost sharing" means a copayment, coinsurance, a deductible or any other form of financial obligation of a subscriber other than a premium or a share of a premium, or any combination of any of these financial obligations, as defined by the terms of an individual or group health care plan."

     SECTION 6. EFFECTIVE DATE.--The effective date of the provisions of this act is January 1, 2026.

- 4 -