HOUSE BILL 156

53rd legislature - STATE OF NEW MEXICO - first session, 2017

INTRODUCED BY

Deborah A. Armstrong

AN ACT

RELATING TO HEALTH COVERAGE; ENACTING SECTIONS OF THE HEALTH CARE PURCHASING ACT, THE PUBLIC ASSISTANCE ACT, THE NEW MEXICO INSURANCE CODE, THE HEALTH MAINTENANCE ORGANIZATION LAW AND THE NONPROFIT HEALTH CARE PLAN LAW TO REQUIRE COVERAGE FOR DONOR HUMAN MILK FOR AT-RISK INFANTS IN HOSPITAL SETTINGS.

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] DONOR HUMAN MILK COVERAGE--HOSPITAL SETTING.--

          A. A group health plan shall provide coverage for donor human milk to any at-risk newborn enrollee while the at-risk newborn enrollee is in a hospital setting.

          B. As used in this section:

                (1) "at-risk newborn enrollee" means a child who:

                     (a) is enrolled in a group health plan pursuant to the Health Care Purchasing Act;

                     (b) has not been discharged from a hospital setting since birth; and

                     (c) fits one of the following high-risk criteria: 1) was born before the completion of thirty-four weeks of gestation; 2) weighed less than one thousand five hundred grams at birth; or 3) was born with a congenital heart or gastrointestinal abnormality;

                (2) "donor human milk" means human milk provided to a child by a woman who is not the child's biological mother that is collected, pasteurized, stored and distributed in accordance with guidelines established by the human milk banking association of North America; and

                (3) "hospital setting" means a health facility that is licensed by the department of health pursuant to the Public Health Act as a hospital or a freestanding birth center."

     SECTION 2. A new section of the Public Assistance Act is enacted to read:

     "[NEW MATERIAL] DONOR HUMAN MILK COVERAGE--HOSPITAL SETTING.--

          A. The department shall ensure that any medical assistance program provides coverage for donor human milk to any at-risk newborn recipient while the at-risk newborn recipient is in a hospital setting.

          B. As used in this section:

                (1) "at-risk newborn recipient" means a child who:

                     (a) is enrolled in a medical assistance program;

                     (b) has not been discharged from a hospital setting since birth; and

                     (c) fits one of the following high-risk criteria: 1) was born before the completion of thirty-four weeks of gestation; 2) weighed less than one thousand five hundred grams at birth; or 3) was born with a congenital heart or gastrointestinal abnormality;

                (2) "donor human milk" means human milk provided to a child by a woman who is not the child's biological mother that is collected, pasteurized, stored and distributed in accordance with guidelines established by the human milk banking association of North America; and

                (3) "hospital setting" means a health facility that is licensed by the department of health pursuant to the Public Health Act as a hospital or a freestanding birth center."

     SECTION 3. A new section of Chapter 59A, Article 22 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] DONOR HUMAN MILK COVERAGE--HOSPITAL SETTING.--

          A. An individual health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state shall provide coverage for donor human milk to any at-risk newborn insured while the at-risk newborn insured is in a hospital setting.

          B. As used in this section:

                (1) "at-risk newborn insured" means a child who:

                     (a) is enrolled in coverage pursuant to an individual health insurance policy, health care plan or certificate of health insurance that is delivered, issued for delivery or renewed in this state;

                     (b) has not been discharged from a hospital setting since birth; and

                     (c) fits one of the following high-risk criteria: 1) was born before the completion of thirty-four weeks of gestation; 2) weighed less than one thousand five hundred grams at birth; or 3) was born with a congenital heart or gastrointestinal abnormality;

                (2) "donor human milk" means human milk provided to a child by a woman who is not the child's biological mother that is collected, pasteurized, stored and distributed in accordance with guidelines established by the human milk banking association of North America; and

                (3) "hospital setting" means a health facility that is licensed by the department of health pursuant to the Public Health Act as a hospital or a freestanding birth center."

     SECTION 4. A new section of Chapter 59A, Article 23 NMSA 1978 is enacted to read:

     "[NEW MATERIAL] DONOR HUMAN MILK COVERAGE--HOSPITAL SETTING.--

          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 shall provide coverage for donor human milk to any at-risk newborn insured while the at-risk newborn insured is in a hospital setting.

          B. As used in this section:

                (1) "at-risk newborn insured" means a child who:

                     (a) is enrolled in coverage pursuant to 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;

                     (b) has not been discharged from a hospital setting since birth; and

                     (c) fits one of the following high-risk criteria: 1) was born before the completion of thirty-four weeks of gestation; 2) weighed less than one thousand five hundred grams at birth; or 3) was born with a congenital heart or gastrointestinal abnormality;

                (2) "donor human milk" means human milk provided to a child by a woman who is not the child's biological mother that is collected, pasteurized, stored and distributed in accordance with guidelines established by the human milk banking association of North America; and

                (3) "hospital setting" means a health facility that is licensed by the department of health pursuant to the Public Health Act as a hospital or a freestanding birth center."

     SECTION 5. A new section of the Health Maintenance Organization Law is enacted to read:

     "[NEW MATERIAL] DONOR HUMAN MILK COVERAGE--HOSPITAL SETTING.--

          A. An individual or group health maintenance organization contract that is delivered, issued for delivery or renewed in this state shall provide coverage for donor human milk to any at-risk newborn enrollee while the at-risk newborn enrollee is in a hospital setting.

          B. As used in this section:

                (1) "at-risk newborn enrollee" means a child who:

                     (a) is enrolled in coverage pursuant to a health maintenance organization contract that is delivered, issued for delivery or renewed in this state;

                     (b) has not been discharged from a hospital setting since birth; and

                     (c) fits one of the following high-risk criteria: 1) was born before the completion of thirty-four weeks of gestation; 2) weighed less than one thousand five hundred grams at birth; or 3) was born with a congenital heart or gastrointestinal abnormality;

                (2) "donor human milk" means human milk provided to a child by a woman who is not the child's biological mother that is collected, pasteurized, stored and distributed in accordance with guidelines established by the human milk banking association of North America; and

                (3) "hospital setting" means a health facility that is licensed by the department of health pursuant to the Public Health Act as a hospital or a freestanding birth center."

     SECTION 6. A new section of the Nonprofit Health Care Plan Law is enacted to read:

     "[NEW MATERIAL] DONOR HUMAN MILK COVERAGE--HOSPITAL SETTING.--

          A. A health care plan that is delivered, issued for delivery or renewed in this state shall provide coverage for donor human milk to any at-risk newborn subscriber while the at-risk newborn subscriber is in a hospital setting.

          B. As used in this section:

                (1) "at-risk newborn subscriber" means a child who:

                     (a) is enrolled in a health care plan that is delivered, issued for delivery or renewed in this state;

                     (b) has not been discharged from a hospital setting since birth; and

                     (c) fits one of the following high-risk criteria: 1) was born before the completion of thirty-four weeks of gestation; 2) weighed less than one thousand five hundred grams at birth; or 3) was born with a congenital heart or gastrointestinal abnormality;

                (2) "donor human milk" means human milk provided to a child by a woman who is not the child's biological mother that is collected, pasteurized, stored and distributed in accordance with guidelines established by the human milk banking association of North America; and

                (3) "hospital setting" means a health facility that is licensed by the department of health pursuant to the Public Health Act as a hospital or a freestanding birth center."