SENATE BILL 484

56th legislature - STATE OF NEW MEXICO - first session, 2023

INTRODUCED BY

Martin Hickey

AN ACT

RELATING TO HEALTH CARE; AMENDING THE HEALTH CARE PURCHASING ACT TO UPDATE PUBLICLY FUNDED HEALTH CARE AGENCY OBLIGATIONS; DECLARING AN EMERGENCY.

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

     SECTION 1. Section 13-7-5 NMSA 1978 (being Laws 2001, Chapter 351, Section 1) is amended to read:

     "13-7-5. CONSOLIDATED PURCHASING FOR OTHER PERSONS.--

          A. Counties, municipalities, state educational institutions and other political subdivisions that wish to use the consolidated purchasing single process for the procurement of health care benefits shall create or enter into an existing association, cooperative or other mutual alliance to create larger pools of eligible participants.

          B. Counties, municipalities, state educational institutions and other political subdivisions that wish to use the consolidated purchasing single process shall, through their respective association, cooperative or mutual alliance, participate in the subsequent consolidated purchasing single process with the publicly funded health care agencies.

          C. Any state higher education institution that chooses not to participate in the consolidated purchasing single process shall provide a report to the legislative finance committee that explains the institution's decision."

     SECTION 2. Section 13-7-7 NMSA 1978 (being Laws 2001, Chapter 351, Section 3, as amended) is amended to read:

     "13-7-7. CONSOLIDATED ADMINISTRATIVE FUNCTIONS--BENEFIT.--

          A. The publicly funded health care agencies [political subdivisions and other persons participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act may] shall enter into a joint powers agreement pursuant to the Joint Powers Agreements Act [with the publicly funded health care agencies and political subdivisions] to determine assessments or provisions of resources to consolidate, standardize and administer the consolidated purchasing single process and subsequent activities pursuant to the Health Care Purchasing Act. Political subdivisions and other persons participating in the consolidated purchasing single process may enter into the joint powers agreement created by the publicly funded health care agencies. The publicly funded health care agencies, political subdivisions and other persons participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act may enter into contracts with nonpublic persons to provide the service of determining assessments or provision of resources for consolidation, standardization and administrative activities.

          B. The publicly funded health care agencies shall agree to and submit a proposed joint powers agreement to the department of finance and administration and the legislative finance committee no later than July 1, 2023. The legislative finance committee and department of finance and administration may only approve the joint powers agreement if the agreement provides for:

                (1) the development of at least one common, uniform benefit plan design to be offered to the beneficiaries of each of the publicly funded health care agencies; and

                (2) increased transparency of consolidated purchasing by:

                     (a) reporting all claims, utilization and payment data to the all-payer claims database; and

                     (b) annual reporting to the legislative finance committee on topics that include the cost and quality of benefits provided by each medical benefits plan.

          [B.] C. Each agency shall retain its responsibility to determine policy direction of the benefit plans, plan development, training and coordination with respect to participants and its benefits staff, as well as to respond to benefits eligibility inquiries and establish and enforce eligibility rules.

          [C.] D. Notwithstanding Subsection [B] C of this section, publicly funded health care agencies, political subdivisions and other persons participating in the consolidated purchasing single process pursuant to the Health Care Purchasing Act shall provide coverage for children, from birth through three years of age, for or under the family, infant, toddler program administered by the early childhood education and care department, provided eligibility criteria are met, for a maximum benefit of three thousand five hundred dollars ($3,500) annually for medically necessary early intervention services provided as part of an individualized family service plan and delivered by certified and licensed personnel who are working in early intervention programs approved by the early childhood education and care department. No payment under this subsection shall be applied against any maximum lifetime or annual limits specified in the policy, health benefits plan or contract."

     SECTION 3. EMERGENCY.--It is necessary for the public peace, health and safety that this act take effect immediately.