46th legislature - STATE OF NEW MEXICO - first session, 2003

RELATING TO INSURANCE; ENACTING A NEW SECTION OF THE PATIENT PROTECTION ACT TO PROVIDE FOR THE APPOINTMENT AND COMPENSATION OF QUALIFIED INDIVIDUALS TO REVIEW EXTERNAL GRIEVANCE APPEALS.

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

Section 1. Section 59A-57-1 NMSA 1978 (being Laws 1998, Chapter 107, Section 1) is amended to read:

"59A-57-1. SHORT TITLE.--[Sections 1 through 11 of this act] Chapter 59A, Article 57 NMSA 1978 may be cited as the "Patient Protection Act"."

Section 2. A new section of the Patient Protection Act is enacted to read:

"[NEW MATERIAL] EXTERNAL GRIEVANCE APPEALS--APPOINTMENT--COMPENSATION.--

A. The superintendent may appoint one or more qualified individuals to review external grievance appeals.

B. The superintendent shall fix the reasonable compensation of each appointee based upon, but not limited to, compensation amounts suggested by national or state legal or medical professional societies, organizations or associations.

C. Upon completion of the external grievance appeal review, the superintendent shall prepare a detailed statement of compensation due each appointee and shall present the statement to the enrollee's health insurer.

D. The enrollee's health insurer shall pay the compensation directly to each appointee who participated in the external grievance appeal review.

E. The superintendent shall promulgate rules to implement this section."