SENATE BILL 170

50th legislature - STATE OF NEW MEXICO - second session, 2012

INTRODUCED BY

Timothy Z. Jennings

AN ACT

RELATING TO PUBLIC ASSISTANCE; UPDATING MEDICAID PAYMENT FOR PHYSICIAN SERVICES.

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

     SECTION 1. Section 27-2-12.3 NMSA 1978 (being Laws 1987, Chapter 269, Section 1, as amended) is amended to read:

     "27-2-12.3. MEDICAID REIMBURSEMENT--EQUAL PAY FOR EQUAL PHYSICIANS', DENTISTS', OPTOMETRISTS', PODIATRISTS' AND PSYCHOLOGISTS' SERVICES.--

          A. The human services department shall establish a rate for the reimbursement of physicians, dentists, optometrists, podiatrists and psychologists for services rendered to medicaid [patients] recipients that provides equal reimbursement for the same or similar services rendered without respect to:

                (1) the date on which [such] the physician, dentist, optometrist, podiatrist or psychologist entered into practice in New Mexico;

                (2) the date on which the physician, dentist, optometrist, podiatrist or psychologist entered into an agreement or contract to provide [such] services to medicaid recipients; or

                (3) the location in which [such] medicaid services are to be provided in the state [provided, however, that].

          B. The requirements of Subsection A of this section [shall not] apply [when the human services] to department contracts with managed care entities pursuant to Subsection A of Section 27-2-12.6 NMSA 1978 [to negotiate a rate for the reimbursement for services rendered to medicaid patients in the medicaid managed care system].

          C. The department shall update reimbursement of physician services rendered to medicaid patients to a rate that, at a minimum, is equal to one hundred five percent of the medicare "Part B" physician fee schedule for New Mexico in effect on December 31, 2010.

          D. The reimbursement update authorized in Subsection C of this section shall apply to:

                (1) physician services furnished to medicaid recipients on or after July 1, 2012; and

                (2) department contracts with managed care entities that are entered into or renewed on or after July 1, 2012 and that include physician services furnished to medicaid recipients."

- 3 -