HOUSE BILL 268

48th legislature - STATE OF NEW MEXICO - second session, 2008

INTRODUCED BY

Keith J. Gardner

AN ACT

RELATING TO HEALTH CARE; REQUIRING MEDICAL ASSISTANCE BENEFICIARIES TO SHARE IN COVERAGE COSTS; REQUIRING THE HUMAN SERVICES DEPARTMENT TO REQUEST A WAIVER FROM THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES.

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

     Section 1. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] COVERAGE COST-SHARING BY MEDICAL ASSISTANCE RECIPIENTS.--

          A. The department shall promulgate rules to implement the following coverage cost-sharing measures for medical assistance recipients:

                (1) a premium assessment for recipients who meet criteria determined by the department;

                (2) an assessment of copayments for emergency room services in amounts comparable to copayments charged by commercial health insurers or health maintenance organizations, with the following conditions:

                     (a) a recipient shall not be charged a copayment when the recipient is admitted as a hospital inpatient as a result of the emergency room evaluation; and

                     (b) the emergency room provider shall make a good-faith effort to collect the copayment from the recipient; and

                (3) an assessment of copayment for those prescription drugs designated by the department in order to provide incentives for greater use of generic prescription drugs when there is a generic or lower-cost equivalent available.

          B. The department shall ensure that the coverage cost-sharing requirements described in Subsection A of this section are in compliance with federal requirements and shall apply for any waivers that the federal department of health and human services or the federal Social Security Act requires to institute these coverage cost-sharing measures."

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